Provider Demographics
NPI:1710077961
Name:L AND P MEDICAL GROUP INC
Entity Type:Organization
Organization Name:L AND P MEDICAL GROUP INC
Other - Org Name:LA PAZ MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LOGHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-380-9999
Mailing Address - Street 1:1107 S ALVARADO ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-4161
Mailing Address - Country:US
Mailing Address - Phone:213-380-9999
Mailing Address - Fax:213-380-7904
Practice Address - Street 1:1107 S ALVARADO ST STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-4161
Practice Address - Country:US
Practice Address - Phone:213-380-9999
Practice Address - Fax:213-380-7904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0066660Medicaid
CAW11107Medicare PIN
CAGR0066660Medicaid