Individual
HEAVEEN AHDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
215 W JANSS RD, THOUSAND OAKS, CA 91360-1847
(805) 497-2727
Mailing address
20807 VERCELLI WAY, PORTER RANCH, CA 91326-4309
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4351047820
MI
207P00000X
Emergency Medicine Physician
Primary
A194410
CA
Other
Enumeration date
05/14/2021
Last updated
10/06/2024
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