Provider Demographics
NPI:1356411904
Name:MOLAIE, MAJID (MD)
Entity type:Individual
Prefix:
First Name:MAJID
Middle Name:
Last Name:MOLAIE
Suffix:
Gender:M
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:PO BOX 6189
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90734-6189
Mailing Address - Country:US
Mailing Address - Phone:310-514-8034
Mailing Address - Fax:310-833-3508
Practice Address - Street 1:28924 S. WESTERN AVE.
Practice Address - Street 2:#201
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0885
Practice Address - Country:US
Practice Address - Phone:310-514-8034
Practice Address - Fax:310-833-3508
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37634174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE71218Medicare UPIN
CAA37634Medicare ID - Type Unspecified