Provider Demographics
NPI:1891070066
Name:KAMRAN KALPARI MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:KAMRAN KALPARI MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALPARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-659-0123
Mailing Address - Street 1:8797 BEVERLY BLVD
Mailing Address - Street 2:315
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1832
Mailing Address - Country:US
Mailing Address - Phone:310-659-0123
Mailing Address - Fax:310-659-7780
Practice Address - Street 1:8797 BEVERLY BLVD
Practice Address - Street 2:315
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1832
Practice Address - Country:US
Practice Address - Phone:310-659-0123
Practice Address - Fax:310-659-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75275261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF93625Medicare UPIN