Provider Demographics
NPI:1144427568
Name:DADGOSTAR, HAJIR (MD)
Entity Type:Individual
Prefix:
First Name:HAJIR
Middle Name:
Last Name:DADGOSTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16500 VENTURA BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2011
Mailing Address - Country:US
Mailing Address - Phone:818-788-9333
Mailing Address - Fax:818-788-9273
Practice Address - Street 1:16500 VENTURA BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2011
Practice Address - Country:US
Practice Address - Phone:818-788-9333
Practice Address - Fax:818-788-9273
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90804207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology