Basic Information
| Provider Information | |||||||||
| NPI: | 1134511082 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOVAHEDI-SMITH | ||||||||
| FirstName: | ZOHREH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | MOVAHEDI SMITH | ||||||||
| OtherFirstName: | ZOHREH | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5601 DE SOTO AVE | ||||||||
| Address2: | NORTHSIDE BUILDING, 2ND FLOOR | ||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913676701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187192000 | ||||||||
| FaxNumber: | 8187194220 | ||||||||
| Practice Location | |||||||||
| Address1: | 5601 DE SOTO AVE | ||||||||
| Address2: | NORTHSIDE BUILDING, 2ND FLOOR | ||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913676701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187192000 | ||||||||
| FaxNumber: | 8187194220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2015 | ||||||||
| LastUpdateDate: | 01/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A133284 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.