Individual
PARVANEH MOHEBAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLS
Contact information
Practice address
5635 CAHUENGA BLVD, NORTH HOLLYWOOD, CA 91601-2104
(818) 308-7450
(818) 308-7795
Mailing address
1407 HILLSIDE DR, GLENDALE, CA 91208-2416
(818) 547-9870
(818) 547-9870
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
MTA44130
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24
CLS
CA
01
—
MTA 44130
CLS
CA
Enumeration date
03/29/2012
Last updated
03/29/2012
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