Provider Demographics
NPI:1568549376
Name:TORCHIZY, ALIREZA (MD)
Entity Type:Individual
Prefix:
First Name:ALIREZA
Middle Name:
Last Name:TORCHIZY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N CENTRAL AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-5000
Mailing Address - Country:US
Mailing Address - Phone:818-789-9393
Mailing Address - Fax:818-789-9392
Practice Address - Street 1:16661 VENTURA BLVD
Practice Address - Street 2:#105
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-243-1513
Practice Address - Fax:818-956-5600
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA048550207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48550OtherMEDICARE ID
E62307Medicare UPIN