Provider Demographics
NPI:1811242845
Name:PARVIZ NAZAR M.D. INC.
Entity type:Organization
Organization Name:PARVIZ NAZAR M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARVIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-343-2345
Mailing Address - Street 1:6670 RESEDA BLVD
Mailing Address - Street 2:#100
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-5327
Mailing Address - Country:US
Mailing Address - Phone:818-343-2345
Mailing Address - Fax:818-343-6789
Practice Address - Street 1:6670 RESEDA BLVD
Practice Address - Street 2:#100
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5327
Practice Address - Country:US
Practice Address - Phone:818-343-2345
Practice Address - Fax:818-343-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40027174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40027Medicare UPIN