Basic Information
Provider Information
NPI: 1114191186
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESHAGHIAN
FirstName: PATRICIA
MiddleName: HEDIEH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018807
FaxNumber: 3103018751
Practice Location
Address1: UCLA DIVISION OF PULMONARY AND CRITICAL CARE
Address2: CHS 37-131
City: LOS ANGELES
State: CA
PostalCode: 900950001
CountryCode: US
TelephoneNumber: 3108255615
FaxNumber: 3102068622
Other Information
ProviderEnumerationDate: 04/21/2008
LastUpdateDate: 12/15/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/15/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XA93356CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


Home