Provider Demographics
NPI:1841756970
Name:AMIR ROWSHANRAD MD INC
Entity Type:Organization
Organization Name:AMIR ROWSHANRAD MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:ELIJAH
Authorized Official - Last Name:RAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-825-7603
Mailing Address - Street 1:16661 VENTURA BLVD STE 707
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4825
Mailing Address - Country:US
Mailing Address - Phone:818-825-7603
Mailing Address - Fax:818-715-1722
Practice Address - Street 1:16661 VENTURA BLVD STE 707
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4825
Practice Address - Country:US
Practice Address - Phone:818-825-7603
Practice Address - Fax:818-715-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty