Provider Demographics
NPI:1699360164
Name:VAHEDIFAR PIROUZ MEDICAL PARTNERSHIP
Entity Type:Organization
Organization Name:VAHEDIFAR PIROUZ MEDICAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHEDIFAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-288-0808
Mailing Address - Street 1:PO BOX 17173
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-3173
Mailing Address - Country:US
Mailing Address - Phone:310-288-0808
Mailing Address - Fax:
Practice Address - Street 1:5901 W OLYMPIC BLVD STE 209
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4663
Practice Address - Country:US
Practice Address - Phone:310-288-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty