Individual
DR. NASTARAN FATEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1516 COTNER AVE, LOS ANGELES, CA 90025-3303
(310) 445-2951
(310) 479-1459
Mailing address
1516 COTNER AVE, LOS ANGELES, CA 90025-3303
(310) 445-2951
(310) 479-1459
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A87404
CA
2085R0202X
Diagnostic Radiology Physician
MD-46189
IA
2085R0202X
Diagnostic Radiology Physician
Primary
MD2024-0053
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A874040
BLUE SHIELD
CA
05
—
00A874040
—
CA
05
—
GR0106035
—
CA
05
—
GR0106039
—
CA
Enumeration date
06/04/2006
Last updated
02/12/2025
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