Organization
AMIR HEDAYATI-RAD M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMIR H HEDAYATI-RAD M.D. (OWNER)
(818) 507-6404
Entity
Organization
Contact information
Practice address
706 W BROADWAY # 100, GLENDALE, CA 91204-1032
(818) 507-6404
(818) 507-6406
Mailing address
163 GRANDVILLE AVENUE, LOS ANGELES, CA 90049-4224
(818) 507-6404
(818) 507-6406
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
A60239
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
A60239
CA
207RI0011X
Interventional Cardiology Physician
A60239
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A602390
—
CA
01
—
DE8474
RAILROAD MEDICARE GRP
CA
Enumeration date
06/28/2007
Last updated
05/20/2020
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