Provider Demographics
NPI:1346583374
Name:KATAYOUN MOTLAGH M.D., INC.
Entity Type:Organization
Organization Name:KATAYOUN MOTLAGH M.D., INC.
Other - Org Name:KAT MOTLAGH'S HEALTH CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KATAYOUN
Authorized Official - Middle Name:YAZDIZADEH
Authorized Official - Last Name:MOTLAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-455-2420
Mailing Address - Street 1:16350 VENTURA BLVD STE D-225
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-5300
Mailing Address - Country:US
Mailing Address - Phone:661-947-6400
Mailing Address - Fax:661-947-6404
Practice Address - Street 1:833 AUTO CENTER DR STE B
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4488
Practice Address - Country:US
Practice Address - Phone:661-947-6400
Practice Address - Fax:661-947-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA11004B207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty