Individual
SOUDEH KHAYAM-BASHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4237 LONGRIDGE AVE UNIT 103, STUDIO CITY, CA 91604-1876
(818) 268-7089
Mailing address
4237 LONGRIDGE AVE UNIT 103, STUDIO CITY, CA 91604-1876
(818) 268-7089
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95057258
CA
Other
Enumeration date
02/12/2022
Last updated
02/12/2022
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