Mazaheri, Ata

Mazaheri, Ata is an individual health care provider with primary practice located at 1560 E Chevy Chase Dr Suite 450, Glendale CA 91206-4197. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mazaheri, Ata can be contacted via phone (818) 246-3300.

Contact Information

Primary practice address
1560 E Chevy Chase Dr Suite 450 Glendale CA 91206-4197
Phone: (818) 246-3300
Fax: (818) 247-7600
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X A79930 California

Profile Details

NPI number 1164467239
LBN Legal business name Mazaheri, Ata
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated May 13th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164467239 NPPES
California MEDICAID 00A799300

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