Organization
SAN JUDAS MEDICAL GROUP IPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEJAT ROSTAMI M.D. (PRESIDENT)
(323) 957-8787
Entity
Organization
Contact information
Practice address
1075 N WESTERN AVE, LOS ANGELES, CA 90029-2307
(323) 957-8787
Mailing address
1075 N WESTERN AVE, LOS ANGELES, CA 90029-2307
(323) 957-8787
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
07/07/2008
Last updated
11/30/2009
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