Individual
PAYAM SHADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8815 W PICO BLVD, LOS ANGELES, CA 90035-3301
(323) 938-9999
Mailing address
PO BOX 49879, LOS ANGELES, CA 90049-0879
(323) 938-9999
(323) 456-0880
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
A78965
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780615724
MEDICARE
CA
05
—
1780615724
—
CA
Enumeration date
07/06/2006
Last updated
09/26/2024
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