Provider Demographics
NPI:1487186706
Name:YAZDI, MONA (DO)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:
Last Name:YAZDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MONA
Other - Middle Name:T
Other - Last Name:YAZDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:23430 HAWTHORNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4730
Mailing Address - Country:US
Mailing Address - Phone:310-784-5880
Mailing Address - Fax:310-325-3117
Practice Address - Street 1:23430 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4730
Practice Address - Country:US
Practice Address - Phone:310-784-5880
Practice Address - Fax:310-325-3117
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16969207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease