Provider Demographics
NPI:1558393900
Name:IRAJ AKHLAGHI M.D. INC.
Entity Type:Organization
Organization Name:IRAJ AKHLAGHI M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-540-6600
Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:SUITE 730
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4504
Mailing Address - Country:US
Mailing Address - Phone:310-540-6600
Mailing Address - Fax:310-316-8667
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:SUITE 730
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4504
Practice Address - Country:US
Practice Address - Phone:310-540-6600
Practice Address - Fax:310-316-8667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADP0010OtherRAILROAD MEDICARE
A22519Medicare UPIN
CADP0010OtherRAILROAD MEDICARE