Provider Demographics
NPI:1841221587
Name:ISIS UROLOGIC AND TRANSPLANT INSTITUTE, INC.
Entity Type:Organization
Organization Name:ISIS UROLOGIC AND TRANSPLANT INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:NARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-480-8747
Mailing Address - Street 1:2200 W 3RD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1932
Mailing Address - Country:US
Mailing Address - Phone:213-480-0368
Mailing Address - Fax:
Practice Address - Street 1:2200 W 3RD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1932
Practice Address - Country:US
Practice Address - Phone:213-480-8747
Practice Address - Fax:213-480-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83950174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG83950OtherM.D.
CAGR0103210OtherMEDICAL PROVIDER NUMBER
CAW19909Medicare PIN
CAG83950OtherM.D.