Provider Demographics
NPI:1558418350
Name:KHORSANDI, PARISA ARMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PARISA
Middle Name:ARMAN
Last Name:KHORSANDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE NUMBER 301
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2304
Mailing Address - Country:US
Mailing Address - Phone:310-449-0093
Mailing Address - Fax:310-449-2940
Practice Address - Street 1:2222 SANTA MONICA BLVD
Practice Address - Street 2:SUITE NUMBER 301
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2304
Practice Address - Country:US
Practice Address - Phone:310-449-0093
Practice Address - Fax:310-994-9204
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71317208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics