Moghaddam, Mohsen Tanbakoochi

Moghaddam, Mohsen Tanbakoochi is an individual health care provider with primary practice located at 19100 Ventura Blvd Ste 16 , Tarzana CA 91356-3234. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Moghaddam, Mohsen Tanbakoochi can be contacted via phone (818) 609-1314.

Contact Information

Primary practice address
19100 Ventura Blvd Ste 16 Tarzana CA 91356-3234
Phone: (818) 609-1314
Fax: (818) 609-0841
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X A46373 California
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X A46373 California
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X A46373 California

Profile Details

NPI number 1720010234
LBN Legal business name Moghaddam, Mohsen Tanbakoochi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated May 29th, 2009 - about 15 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 1720010234 NPPES
California MEDICAID 00A463732

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