Provider Demographics
NPI:1578976221
Name:KOHBODI, GOLENAZ ADELI (MD)
Entity Type:Individual
Prefix:
First Name:GOLENAZ
Middle Name:ADELI
Last Name:KOHBODI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1201 W. LA VETA AVE.
Mailing Address - Street 2:DIVISION OF NEONATOLOGY
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-509-3096
Mailing Address - Fax:714-509-7800
Practice Address - Street 1:1201 W. LA VETA AVE.
Practice Address - Street 2:DIVISION OF NEONATOLOGY
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-509-3096
Practice Address - Fax:714-509-7800
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1553682080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine