Organization
SHAHLA KOHANZADEH MD MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHLA KOHANZADEH M.D (CEO)
(213) 381-1117
Entity
Organization
Contact information
Practice address
803 S ALVARADO ST, LOS ANGELES, CA 90057-4009
(213) 381-1117
(213) 381-5903
Mailing address
803 S ALVARADO ST, LOS ANGELES, CA 90057-4009
(213) 381-1117
(213) 381-5903
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A47964
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A479640
—
CA
Enumeration date
04/26/2011
Last updated
07/14/2011
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