Provider Demographics
NPI:1467405027
Name:INTERNATIONAL ORTHOPEDIC CENTER FOR JOINT DISORDERS A MEDICAL CORP
Entity Type:Organization
Organization Name:INTERNATIONAL ORTHOPEDIC CENTER FOR JOINT DISORDERS A MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HORMOZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:310-659-0989
Mailing Address - Street 1:50 N LA CIENEGA BLVD
Mailing Address - Street 2:100
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2227
Mailing Address - Country:US
Mailing Address - Phone:310-659-0989
Mailing Address - Fax:310-659-3773
Practice Address - Street 1:50 N LA CIENEGA BLVD
Practice Address - Street 2:100
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2227
Practice Address - Country:US
Practice Address - Phone:310-659-0989
Practice Address - Fax:310-659-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38240207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT25168BMedicare ID - Type UnspecifiedANNE MCARTHUR
CAA28576Medicare UPIN
CAWA38240Medicare ID - Type Unspecified
CAW13800Medicare ID - Type Unspecified