Individual
GHAZAL POOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20969 VENTURA BLVD STE 24, WOODLAND HILLS, CA 91364-6622
(310) 425-4810
Mailing address
20969 VENTURA BLVD STE 24, WOODLAND HILLS, CA 91364-6622
(310) 425-4810
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21397
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA21397
PA LICENSE
CA
Enumeration date
10/10/2011
Last updated
08/25/2014
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