Provider Demographics
NPI:1760407829
Name:PARSA, KAMBIZ K (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMBIZ
Middle Name:K
Last Name:PARSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:465 N ROXBURY DR STE 1001
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4213
Mailing Address - Country:US
Mailing Address - Phone:310-777-8880
Mailing Address - Fax:310-248-6258
Practice Address - Street 1:465 N ROXBURY DR STE 1001
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4213
Practice Address - Country:US
Practice Address - Phone:310-777-8880
Practice Address - Fax:310-248-6258
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90293207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48217Medicare ID - Type Unspecified
FLI12753Medicare UPIN