Provider Demographics
NPI:1497056105
Name:EGHBALIEH, NAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:NAVID
Middle Name:
Last Name:EGHBALIEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DIVISION OF VASCULAR & INTERVENTIONAL RADIOLOGY
Mailing Address - Street 2:757 WESTWOOD PLAZA, SUITE 2125
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DIVISION OF VASCULAR & INTERVENTIONAL RADIOLOGY
Practice Address - Street 2:757 WESTWOOD PLAZA, SUITE 2125
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7430
Practice Address - Country:US
Practice Address - Phone:310-267-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1361552085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology