Provider Demographics
NPI:1508146739
Name:NOURANI, DAN (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:NOURANI
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 1:101 OCEAN AVE
Mailing Address - Street 2:D 602
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-1405
Mailing Address - Country:US
Mailing Address - Phone:805-748-8244
Mailing Address - Fax:
Practice Address - Street 1:101 OCEAN AVE
Practice Address - Street 2:D 602
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90402-1405
Practice Address - Country:US
Practice Address - Phone:805-748-8244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40994207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease