Provider Demographics
NPI:1790943355
Name:GHAFOURI, ROYA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROYA
Middle Name:
Last Name:GHAFOURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 WILSHIRE BLVD STE 421
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2113
Mailing Address - Country:US
Mailing Address - Phone:310-990-0905
Mailing Address - Fax:424-204-1459
Practice Address - Street 1:9735 WILSHIRE BLVD STE 421
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2113
Practice Address - Country:US
Practice Address - Phone:310-990-0905
Practice Address - Fax:424-204-1459
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115937207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery