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:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164467239 | NPPES |
| California | MEDICAID | 00A799300 |
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