Individual
DR. BIJAN MOTAMEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 902-2990
(818) 904-3793
Mailing address
2550 N HOLLYWOOD WAY, SUITE 209, BURBANK, CA 91505-1055
(818) 557-0135
(818) 557-1394
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A76326
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A763260
BLUE SHIELD
CA
05
—
00A763260
—
CA
01
—
050126CH40965
VALLEY PRES TRAILBLAZER
CA
01
—
A76326
BLUE CROSS
CA
Enumeration date
06/02/2006
Last updated
07/09/2007
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