| Sassan Davoudi, Md Pc | |
|
5071 Garden Grove Ave Tarzana CA 91356-4317 | |
| (818) 345-6655 | |
| Not Available |
| Full Name | Sassan Davoudi, Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5071 Garden Grove Ave, Tarzana, California |
| Authorized Official Name and Position | Sassan Davoudi (PRESIDENT) |
| Authorized Official Contact | 8183456655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sassan Davoudi, Md Pc 5071 Garden Grove Ave Tarzana CA 91356-4317 Ph: (818) 345-6655 | Sassan Davoudi, Md Pc 5071 Garden Grove Ave Tarzana CA 91356-4317 Ph: (818) 345-6655 |
| NPI Number | 1194091496 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 03/30/2012 |
| Medicare PECOS PAC ID | 9739342510 |
|---|---|
| Medicare Enrollment ID | O20120514000615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194091496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sassan Davoudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821215302 PECOS PAC ID: 8022039510 Enrollment ID: I20051212000889 |
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