Basic Information
Provider Information
NPI: 1720374135
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SALEHIRAD
FirstName: RAMIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 200 MEDICAL PLAZA SUITE 365B
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900957417
CountryCode: US
TelephoneNumber: 3108257921
FaxNumber: 3107946553
Other Information
ProviderEnumerationDate: 06/23/2011
LastUpdateDate: 09/05/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XA123836CAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001XA123836CAY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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