Provider Demographics
NPI:1013214972
Name:LAHIJI MEDICAL INC
Entity Type:Organization
Organization Name:LAHIJI MEDICAL INC
Other - Org Name:PARVIZ LAHIJI, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARVIZ
Authorized Official - Middle Name:ASHER
Authorized Official - Last Name:LAHIJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-907-7070
Mailing Address - Street 1:16311 VENTURA BLVD
Mailing Address - Street 2:SUITE 907
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2124
Mailing Address - Country:US
Mailing Address - Phone:818-907-7070
Mailing Address - Fax:818-907-7157
Practice Address - Street 1:16311 VENTURA BLVD
Practice Address - Street 2:SUITE 907
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2124
Practice Address - Country:US
Practice Address - Phone:818-907-7070
Practice Address - Fax:818-907-7157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42614261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A4216140Medicaid
CAA42614Medicare PIN
CA00A4216140Medicaid