Provider Demographics
NPI:1639664030
Name:COMPREHENSIVE HOSPITALIST & AMBULATORY PHYSICIANS-HOSPITALISTS
Entity Type:Organization
Organization Name:COMPREHENSIVE HOSPITALIST & AMBULATORY PHYSICIANS-HOSPITALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUFERSADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-905-9586
Mailing Address - Street 1:5000 VAN NUYS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1717
Mailing Address - Country:US
Mailing Address - Phone:818-572-1490
Mailing Address - Fax:818-572-1491
Practice Address - Street 1:5000 VAN NUYS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1717
Practice Address - Country:US
Practice Address - Phone:818-572-1490
Practice Address - Fax:818-572-1491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12379208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty