Provider Demographics
NPI:1518054915
Name:TOURAH, MORAD (MD)
Entity Type:Individual
Prefix:
First Name:MORAD
Middle Name:
Last Name:TOURAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MORAD
Other - Middle Name:H
Other - Last Name:AKHONDZADEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1897
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90406-1897
Mailing Address - Country:US
Mailing Address - Phone:310-429-3326
Mailing Address - Fax:
Practice Address - Street 1:3756 SANTA ROSALIA DR STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008
Practice Address - Country:US
Practice Address - Phone:310-742-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54059208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery