Organization
CARDIOLOGY VASCULAR & ENDOCRINOLOGY CENTER PROFESSIONAL CORPORATION
Active
Organization
CARDIOLOGY VASCULAR & ENDOCRINOLOGY CENTER PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAZAI BAHRAM M.D. (OWNER/PRESIDENT)
(615) 557-6692
Entity
Organization
Contact information
Practice address
2220 LYNN RD, THOUSAND OAKS, CA 91360-1904
(661) 395-3055
Mailing address
2220 LYNN RD, THOUSAND OAKS, CA 91360-1904
(661) 395-3055
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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