Provider Demographics
NPI:1245256650
Name:MEHMET C DEMIROZU M D INC
Entity type:Organization
Organization Name:MEHMET C DEMIROZU M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PULMONALOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHMET
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEMIROZU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-644-9515
Mailing Address - Street 1:PO BOX 641245
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-6245
Mailing Address - Country:US
Mailing Address - Phone:310-644-9515
Mailing Address - Fax:310-644-3629
Practice Address - Street 1:4477 W 118TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2255
Practice Address - Country:US
Practice Address - Phone:310-644-9515
Practice Address - Fax:310-644-3629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52940207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A52900Medicaid
CAG01575Medicare UPIN
CAA52940Medicare ID - Type Unspecified