Provider Demographics
NPI:1437527199
Name:ROYA H GHAFOURI MD INC
Entity Type:Organization
Organization Name:ROYA H GHAFOURI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAFOURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-867-1270
Mailing Address - Street 1:9919 ANTHONY PL
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-2001
Mailing Address - Country:US
Mailing Address - Phone:310-867-1270
Mailing Address - Fax:
Practice Address - Street 1:9735 WILSHIRE BLVD STE 421
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2113
Practice Address - Country:US
Practice Address - Phone:310-990-0905
Practice Address - Fax:424-204-1459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115937207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty