Individual
DR. MANOOCHEHR KOUKHAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3513 WHITTIER BLVD, LOS ANGELES, CA 90023-1709
(323) 262-1814
(323) 262-1699
Mailing address
3325 OAKRIDGE TER, CALABASAS, CA 91302-3203
(818) 224-3402
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C42744
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C42744
MEDICAL LICENSE
CA
Enumeration date
02/15/2007
Last updated
06/24/2014
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