| Ashkan E Sefaradi Inc | |
|
9808 Venice Blvd Ste 707 Culver City CA 90232-6802 | |
| (310) 845-6245 | |
| Not Available |
| Full Name | Ashkan E Sefaradi Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9808 Venice Blvd Ste 707, Culver City, California |
| Authorized Official Name and Position | Ashkan Sefaradi (OWNER) |
| Authorized Official Contact | 3108456245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashkan E Sefaradi Inc 1426 Cardiff Ave Los Angeles CA 90035-3205 Ph: (310) 845-6245 | Ashkan E Sefaradi Inc 9808 Venice Blvd Ste 707 Culver City CA 90232-6802 Ph: (310) 845-6245 |
| NPI Number | 1538759238 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 07/15/2021 |
| Medicare PECOS PAC ID | 5496162182 |
|---|---|
| Medicare Enrollment ID | O20210324003093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538759238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ashkan Eliahou Sefaradi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861802548 PECOS PAC ID: 8224383443 Enrollment ID: I20180612001445 |
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