Provider Demographics
NPI:1881070241
Name:KALANTARI, JALIL (MD)
Entity type:Individual
Prefix:DR
First Name:JALIL
Middle Name:
Last Name:KALANTARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON ST RM B-622
Mailing Address - Street 2:LOMA LINDA UNIVERSITY MEDICAL CENTER
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-1716
Mailing Address - Country:US
Mailing Address - Phone:909-558-1000
Mailing Address - Fax:909-651-5489
Practice Address - Street 1:323 N PRAIRIE AVE STE 114
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4503
Practice Address - Country:US
Practice Address - Phone:310-674-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1459392085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology