Provider Demographics
NPI:1750777553
Name:MOSHAYEDI, POURIA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:POURIA
Middle Name:
Last Name:MOSHAYEDI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 WESTWOOD PLAZA, RM 1-240
Mailing Address - Street 2:ATTN: POURIA MOSHAYEDI, NEUROLOGY EDUCATION OFFICE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8353
Mailing Address - Country:US
Mailing Address - Phone:310-825-6681
Mailing Address - Fax:310-206-4733
Practice Address - Street 1:710 WESTWOOD PLAZA, RM 1-240
Practice Address - Street 2:ATTN: POURIA MOSHAYEDI, NEUROLOGY EDUCATION OFFICE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8353
Practice Address - Country:US
Practice Address - Phone:310-825-6681
Practice Address - Fax:310-206-4733
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program