Provider Demographics
NPI:1073633459
Name:AMID, PARVIZ K (MD)
Entity Type:Individual
Prefix:DR
First Name:PARVIZ
Middle Name:K
Last Name:AMID
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:24620 CORDILLERA DR
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2511
Mailing Address - Country:US
Mailing Address - Phone:818-222-8809
Mailing Address - Fax:818-222-9553
Practice Address - Street 1:200 MEDICAL PLAZA
Practice Address - Street 2:SUITE 214
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:818-222-8809
Practice Address - Fax:818-222-9553
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA33748208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A337480Medicaid
CA00A337480Medicaid
CAWA33748JMedicare PIN