Provider Demographics
NPI:1639468093
Name:NEW CENTURY INSTITUTE FOR UROLOGY & ANDROLOGY A.P.M.C.
Entity Type:Organization
Organization Name:NEW CENTURY INSTITUTE FOR UROLOGY & ANDROLOGY A.P.M.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOROUSH
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:RAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-760-2800
Mailing Address - Street 1:P.O. BOX 55109
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91413-0109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12922 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-2924
Practice Address - Country:US
Practice Address - Phone:818-760-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60294208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty