Individual
DR. GHOLAM REZA BERENJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11301 WILSHIRE BLVD, NUCLEAR MEDICINE (115), LOS ANGELES, CA 90073
(310) 268-3583
Mailing address
15 DEL CARLO, IRVINE, CA 92606-8823
(949) 735-3714
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
A96398
CA
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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