Provider Demographics
NPI:1841480092
Name:BAHRAM ZAMANIAN, MD, APMC
Entity type:Organization
Organization Name:BAHRAM ZAMANIAN, MD, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-464-8738
Mailing Address - Street 1:200 W ESPLANADE AVE
Mailing Address - Street 2:SUITE 701
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2489
Mailing Address - Country:US
Mailing Address - Phone:504-464-8738
Mailing Address - Fax:504-464-8717
Practice Address - Street 1:200 W ESPLANADE AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2489
Practice Address - Country:US
Practice Address - Phone:504-464-8738
Practice Address - Fax:504-464-8717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.04022R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1568404747OtherNPI INDIVIDUAL
LA1193844Medicaid
LAB61145Medicare UPIN
LA5C207Medicare PIN