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Organization

POUYA LAVIAN MD INC A MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. POUYA LAVIAN MD (PRESIDENT)
(818) 394-0884
Entity
Organization

Contact information

Practice address
16661 VENTURA BLVD STE 820, ENCINO, CA 91436-4801
(818) 394-0884
(818) 217-8318
Mailing address
16661 VENTURA BLVD STE 820, ENCINO, CA 91436-4801
(818) 394-0884
(818) 217-8318

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
A109429
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A109429
LICENSE
CA
Enumeration date
12/30/2013
Last updated
02/18/2014
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