Provider Demographics
NPI:1962633289
Name:AFSARI, ROUZBEH (MD)
Entity Type:Individual
Prefix:
First Name:ROUZBEH
Middle Name:
Last Name:AFSARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1500 S CENTRAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2530
Mailing Address - Country:US
Mailing Address - Phone:818-242-0475
Mailing Address - Fax:818-662-0260
Practice Address - Street 1:18433 ROSCOE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4134
Practice Address - Country:US
Practice Address - Phone:818-349-1262
Practice Address - Fax:818-349-7529
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124032207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology