Provider Demographics
NPI:1578097150
Name:GHORBANIAN, BABAK
Entity Type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:GHORBANIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6433 TOPANGA CANYON BLVD
Mailing Address - Street 2:# 125
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2621
Mailing Address - Country:US
Mailing Address - Phone:818-451-6951
Mailing Address - Fax:747-226-3242
Practice Address - Street 1:4241 TOSCA RD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-6033
Practice Address - Country:US
Practice Address - Phone:818-451-6951
Practice Address - Fax:747-226-3242
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter