Provider Demographics
NPI:1184913592
Name:NAZAR, HOOMAN JEFF (DO)
Entity type:Individual
Prefix:DR
First Name:HOOMAN
Middle Name:JEFF
Last Name:NAZAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18034 VENTURA BLVD
Mailing Address - Street 2:#125
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18034 VENTURA BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3516
Practice Address - Country:US
Practice Address - Phone:818-343-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11459207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology