Provider Demographics
NPI:1083859342
Name:MEHRDAD RAZAVI MD INC
Entity Type:Organization
Organization Name:MEHRDAD RAZAVI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-938-5252
Mailing Address - Street 1:1844 SAN MIGUEL DR
Mailing Address - Street 2:SUITE 316
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4962
Mailing Address - Country:US
Mailing Address - Phone:925-938-5252
Mailing Address - Fax:925-938-1343
Practice Address - Street 1:1844 SAN MIGUEL DR
Practice Address - Street 2:SUITE 316
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4962
Practice Address - Country:US
Practice Address - Phone:925-938-5252
Practice Address - Fax:925-938-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty