Modaresi, Azadeh
Modaresi, Azadeh is an sole proprietor health care provider with primary practice located at 6730A White Oak Ave , Van Nuys CA 91406. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Modaresi, Azadeh can be contacted via phone (818) 668-8898.Contact Information
Primary practice address
6730A White Oak Ave
Van Nuys CA 91406
Phone: (818) 668-8898
Fax: (818) 668-8893
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A70235 | California |
Profile Details
| NPI number | 1992707004 |
|---|---|
| LBN Legal business name | Modaresi, Azadeh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1992707004 | NPPES |
| California | MEDICAID | A70235 |
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