Individual
DR. AZADEH MODARESI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6730A WHITE OAK AVE, VAN NUYS, CA 91406
(818) 668-8898
(818) 668-8893
Mailing address
PO BOX 547, WOODLAND HILLS, CA 91365-0547
(818) 668-8898
(918) 668-8893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A70235
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A70235
—
CA
Enumeration date
06/01/2005
Last updated
07/08/2007
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