Provider Demographics
NPI:1356115687
Name:ARIEL MORADZADEH MD, INC
Entity type:Organization
Organization Name:ARIEL MORADZADEH MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-869-3213
Mailing Address - Street 1:152 S ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-3802
Mailing Address - Country:US
Mailing Address - Phone:310-869-3213
Mailing Address - Fax:
Practice Address - Street 1:414 N CAMDEN DR STE 650
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4513
Practice Address - Country:US
Practice Address - Phone:310-278-1594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty