Provider Demographics
NPI:1477147965
Name:ARDALAN ALEN NOURIAN, MD, APC
Entity Type:Organization
Organization Name:ARDALAN ALEN NOURIAN, MD, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARDALAN
Authorized Official - Middle Name:ALEN
Authorized Official - Last Name:NOURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-416-1777
Mailing Address - Street 1:PO BOX 15426
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-1426
Mailing Address - Country:US
Mailing Address - Phone:805-416-1777
Mailing Address - Fax:310-606-2039
Practice Address - Street 1:301 SCIENCE DR STE 190
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-0800
Practice Address - Country:US
Practice Address - Phone:805-416-1777
Practice Address - Fax:310-606-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty