Individual
DR. KHODAM-RAD PAYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17525 VENTURA BLVD, SUITE 203, ENCINO, CA 91316-3843
(818) 986-0200
(818) 986-4393
Mailing address
17525 VENTURA BLVD, SUITE 203, ENCINO, CA 91316-3843
(818) 986-0200
(818) 986-4393
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A75190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A75190
CA LICENSE
CA
Enumeration date
09/02/2006
Last updated
09/22/2008
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