Provider Demographics
NPI:1205384419
Name:AMIR PARVINCHI MD INC
Entity Type:Organization
Organization Name:AMIR PARVINCHI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:PARVINCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-755-0207
Mailing Address - Street 1:12737 GLENOAKS BLVD
Mailing Address - Street 2:# 26
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4704
Mailing Address - Country:US
Mailing Address - Phone:818-362-1758
Mailing Address - Fax:
Practice Address - Street 1:12737 GLENOAKS BLVD
Practice Address - Street 2:# 26
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4704
Practice Address - Country:US
Practice Address - Phone:818-362-1758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty