Provider Demographics
NPI:1750301339
Name:LAHIJI, PEJMAN DAVID (MD)
Entity type:Individual
Prefix:
First Name:PEJMAN
Middle Name:DAVID
Last Name:LAHIJI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 BALBOA BLVD # 367
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3402
Mailing Address - Country:US
Mailing Address - Phone:423-315-9172
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:4924 BALBOA BLVD # 367
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3402
Practice Address - Country:US
Practice Address - Phone:423-315-9172
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME161344207L00000X
CAA85860207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A858600Medicaid
CAGR0084040OtherGROUP MEDICAID
CAW13274OtherGROUP MEDICARE
CA3094032OtherMEDICAID PIN
CA00A858600OtherBLUE SHIELD
CAWA85860AMedicare PIN
CA00A858600Medicaid