Provider Demographics
NPI:1245474378
Name:BOROUJERDI-RAD, LALEH (MD)
Entity type:Individual
Prefix:DR
First Name:LALEH
Middle Name:
Last Name:BOROUJERDI-RAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14350 WHITTIER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2164
Mailing Address - Country:US
Mailing Address - Phone:562-907-7616
Mailing Address - Fax:
Practice Address - Street 1:14350 WHITTIER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2164
Practice Address - Country:US
Practice Address - Phone:562-907-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114999207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology