Organization
SIAMAK STEPHEN MARZBAN,M.D.,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIAMAK STEPHEN MARZBAN M.D. (PRESIDENT)
(310) 832-2694
Entity
Organization
Contact information
Practice address
2403 S MORAY AVE, SAN PEDRO, CA 90732-4342
(310) 832-2694
(310) 547-0140
Mailing address
2403 S MORAY AVE, SAN PEDRO, CA 90732-4342
(310) 832-2694
(310) 547-0140
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A048221
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A482211
—
CA
Enumeration date
11/04/2010
Last updated
11/04/2010
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