Basic Information
Provider Information
NPI: 1366679508
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NOUR
FirstName: MAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD
Address2: SUITE 400
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 757 WESTWOOD PLZ STE 1633
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900953075
CountryCode: US
TelephoneNumber: 3103016800
FaxNumber: 3107949035
Other Information
ProviderEnumerationDate: 06/15/2009
LastUpdateDate: 01/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085N0700XA115026CAN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085R0202XA115026CAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0204XA115026CAN Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
2084V0102XA115026CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology

No ID Information.


Home