Provider Demographics
NPI:1700073772
Name:TAHSINI, MEHDI (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHDI
Middle Name:
Last Name:TAHSINI
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 1:143 S BROADWAY APT E
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3338
Mailing Address - Country:US
Mailing Address - Phone:310-990-4327
Mailing Address - Fax:
Practice Address - Street 1:2573 PACIFIC COAST HWY STE B
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7950
Practice Address - Country:US
Practice Address - Phone:310-990-4327
Practice Address - Fax:310-347-4054
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101847261QU0200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies