Individual
KIA NIKOOMANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 843-5864
Mailing address
2625 W ALAMEDA AVE STE 506, BURBANK, CA 91505-4816
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
20A16582
CA
207RP1001X
Pulmonary Disease Physician
Primary
20A16582
CA
Other
Enumeration date
04/11/2016
Last updated
05/24/2023
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