Provider Demographics
NPI:1497019806
Name:AHMADI, NASER (MD MS PHD)
Entity Type:Individual
Prefix:DR
First Name:NASER
Middle Name:
Last Name:AHMADI
Suffix:
Gender:M
Credentials:MD MS PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20757 BERMUDA ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1502
Mailing Address - Country:US
Mailing Address - Phone:310-803-0443
Mailing Address - Fax:
Practice Address - Street 1:760 WESTWOOD PLZ STE 48-240
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5055
Practice Address - Country:US
Practice Address - Phone:310-803-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1322822084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
70816OtherPSYCHIATRY
10092OtherCHILD AND ADOLESCENT PSYCHIATRY