Provider Demographics
NPI:1932124328
Name:SALEHI, PARVIZ (MD)
Entity Type:Individual
Prefix:
First Name:PARVIZ
Middle Name:
Last Name:SALEHI
Suffix:
Gender:M
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:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91365-1026
Mailing Address - Country:US
Mailing Address - Phone:818-343-5109
Mailing Address - Fax:818-343-8770
Practice Address - Street 1:6670 RESEDA BLVD
Practice Address - Street 2:SUITE # 100
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5327
Practice Address - Country:US
Practice Address - Phone:818-343-5109
Practice Address - Fax:818-343-8770
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39866208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A398860Medicaid
CA00A398860Medicaid
CAA39866AMedicare PIN