Individual
DR. MOHSEN TANBAKOOCHI MOGHADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19100 VENTURA BLVD STE 16, TARZANA, CA 91356-3234
(818) 609-1314
(818) 609-0841
Mailing address
19100 VENTURA BLVD STE 16, TARZANA, CA 91356-3234
(818) 609-1314
(818) 609-0841
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
A46373
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
A46373
CA
208D00000X
General Practice Physician
Primary
A46373
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A463732
—
CA
Enumeration date
07/07/2006
Last updated
05/29/2009
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