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Individual

DR. SOROUSH ADAM RAMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12922 VICTORY BLVD, ASSUTA FAMILY MEDICAL GROUP APMC, NORTH HOLLYWOOD, CA 91606-2924
(818) 760-2800
(818) 760-7343
Mailing address
12922 VICTORY BLVD, ASSUTA FAMILY MEDICAL GROUP APMC, NORTH HOLLYWOOD, CA 91606-2924
(818) 760-2800
(818) 760-7343

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
A60294
CA
208800000X
Urology Physician
Primary
A60294
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A602940
CA
05
00W184600
CA
01
201602227
TAX ID
CA
01
954827961
TAX ID
CA
Enumeration date
05/17/2007
Last updated
01/15/2022
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