Organization
P TAHERPOUR M.D.INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LILO TAHERPOUR (CONTROLLER)
(213) 626-5679
Entity
Organization
Contact information
Practice address
124 N VIGNES ST, LOS ANGELES, CA 90012-4030
(213) 626-5679
(213) 680-0185
Mailing address
124 N VIGNES ST, LOS ANGELES, CA 90012-4030
(213) 626-5679
(213) 680-0185
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A28671
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A286710
—
CA
Enumeration date
02/21/2007
Last updated
08/22/2020
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