Provider Demographics
NPI:1164478160
Name:ANDREWS, AFSANEH BAHMANI (MD)
Entity Type:Individual
Prefix:DR
First Name:AFSANEH
Middle Name:BAHMANI
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MASOUMEH
Other - Middle Name:AFSANEH
Other - Last Name:BAHMANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:381 ARNO WAY
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272
Mailing Address - Country:US
Mailing Address - Phone:310-383-3317
Mailing Address - Fax:310-230-7757
Practice Address - Street 1:381 ARNO WAY
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3348
Practice Address - Country:US
Practice Address - Phone:310-383-3317
Practice Address - Fax:310-230-7757
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61989207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A619890OtherBLUE SHIELD
CA00A619890328OtherCALOPTIMA
CA050088929OtherRAILROAD MEDICARE
CA00A619890Medicaid
CAWA61989AMedicare ID - Type Unspecified
CA00A619890Medicaid