Provider Demographics
NPI:1649406778
Name:BORNA, REZA MEHRYAR (MD)
Entity Type:Individual
Prefix:DR
First Name:REZA
Middle Name:MEHRYAR
Last Name:BORNA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ STE 3325
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3714
Practice Address - Country:US
Practice Address - Phone:310-267-8653
Practice Address - Fax:310-267-3899
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2024-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC138643207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology