Organization
ETEHAD M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIAMAK ETEHAD MD (MEDICAL DIRECTOR)
(818) 812-9466
Entity
Organization
Contact information
Practice address
7667 WINNETKA AVE, WINNETKA, CA 91306-2677
(818) 812-9466
(818) 678-9849
Mailing address
7667 WINNETKA AVE, WINNETKA, CA 91306-2677
(818) 812-9466
(818) 678-9849
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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