Mahboubi, Soroosh
Mahboubi, Soroosh is an individual health care provider with primary practice located at 3401 Civic Center Blvd Children'S Hospital Of Philadelphia - Radiology, Philadelphia PA 19104-4319. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Pediatric Radiology is his primary health care specialty. Mahboubi, Soroosh can be contacted via phone (215) 590-7000.Contact Information
Primary practice address
3401 Civic Center Blvd Children'S Hospital Of Philadelphia - Radiology
Philadelphia PA 19104-4319
Phone: (215) 590-7000
Fax: (215) 590-9348
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | MD035194L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD035194L | Pennsylvania |
Profile Details
| NPI number | 1043261522 |
|---|---|
| LBN Legal business name | Mahboubi, Soroosh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043261522 | NPPES |
| Pennsylvania | MEDICAID | 0006461470001 |
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