Provider Demographics
NPI:1457507915
Name:TEHRANI, FARAMARZ TAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:FARAMARZ
Middle Name:TAJ
Last Name:TEHRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FARAMARZ
Other - Middle Name:
Other - Last Name:TEHRANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1513 S GRAND AVE
Mailing Address - Street 2:SUITE # 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3070
Mailing Address - Country:US
Mailing Address - Phone:213-742-6400
Mailing Address - Fax:
Practice Address - Street 1:1513 S GRAND AVE
Practice Address - Street 2:SUITE # 400
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3070
Practice Address - Country:US
Practice Address - Phone:213-742-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107378207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease