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Organization

PAYAM VAHEDIFAR MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAYAM VAHEDIFAR M.D. (PHYSICIAN & OWNER)
(310) 795-5645
Entity
Organization

Contact information

Practice address
16633 VENTURA BLVD, SUITE 802, ENCINO, CA 91436-1824
(818) 986-0200
(818) 986-4393
Mailing address
16633 VENTURA BLVD, SUITE 802, ENCINO, CA 91436-1824
(818) 986-0200
(818) 986-4393

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
A63617
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1861473464
INDIVIDUAL NPI
Enumeration date
10/23/2007
Last updated
04/11/2017
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