Individual
DR. GHOLAM REZA MOHAMMADZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
77 ROLLING OAKS DR STE 202, THOUSAND OAKS, CA 91361-1018
(805) 379-6717
(805) 379-6719
Mailing address
77 ROLLING OAKS DR STE 202, THOUSAND OAKS, CA 91361-1018
(805) 379-6717
(805) 379-6719
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G74293
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G742930
—
CA
Enumeration date
03/08/2006
Last updated
06/25/2024
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