Provider Demographics
NPI:1780886762
Name:BEHZAD H NOORIAN MD PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:BEHZAD H NOORIAN MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:HAMEDANI
Authorized Official - Last Name:NOORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-325-4445
Mailing Address - Street 1:23000 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3052
Mailing Address - Country:US
Mailing Address - Phone:310-325-4445
Mailing Address - Fax:310-325-4409
Practice Address - Street 1:23000 CRENSHAW BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3052
Practice Address - Country:US
Practice Address - Phone:310-325-4445
Practice Address - Fax:310-325-4409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-03
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38774207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A387741Medicaid
CAB50386Medicare UPIN
CAA38774AMedicare ID - Type Unspecified