Provider Demographics
NPI:1932428810
Name:DODI, JAMSHID
Entity Type:Individual
Prefix:MR
First Name:JAMSHID
Middle Name:
Last Name:DODI
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:JAMSHID
Other - Middle Name:
Other - Last Name:DODI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12766 PACIFIC AVE
Mailing Address - Street 2:#6
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-4236
Mailing Address - Country:US
Mailing Address - Phone:310-922-0128
Mailing Address - Fax:310-636-1343
Practice Address - Street 1:12766 PACIFIC AVE
Practice Address - Street 2:#6
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-4236
Practice Address - Country:US
Practice Address - Phone:310-922-0128
Practice Address - Fax:310-636-1343
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program