Provider Demographics
NPI:1851669592
Name:NEHZAT NIKAKHTAR MD INC
Entity Type:Organization
Organization Name:NEHZAT NIKAKHTAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURYANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-293-8541
Mailing Address - Street 1:24462 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6507
Mailing Address - Country:US
Mailing Address - Phone:310-373-6169
Mailing Address - Fax:310-373-6169
Practice Address - Street 1:24462 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6507
Practice Address - Country:US
Practice Address - Phone:310-373-6169
Practice Address - Fax:310-373-6169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA367732086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty