Ganjianpour, Mark

Ganjianpour, Mark is an sole proprietor health care provider with primary practice located at 6330 San Vicente Blvd Suite 310, Los Angeles CA 90048-5425. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Ganjianpour, Mark can be contacted via phone (310) 855-0751.

Contact Information

Primary practice address
6330 San Vicente Blvd Suite 310 Los Angeles CA 90048-5425
Fax: (310) 358-2453
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X A71208 California

Profile Details

NPI number 1447229570
LBN Legal business name Ganjianpour, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2006
Last updated Jan 29th, 2014 - 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 1447229570 NPPES
California Other P00068539 RAILROAD MEDICARE
California Other 346434300 RAILROAD MEDICARE
California MEDICAID 00A712080 RAILROAD MEDICARE

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