Individual
JACOB FAHIMIPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23635 COLLINS ST, WOODLAND HILLS, CA 91367-5916
(818) 433-9111
(818) 704-7339
Mailing address
23635 COLLINS ST, WOODLAND HILLS, CA 91367-5916
(818) 433-9111
(818) 704-7339
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
197608576
CA
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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