Provider Demographics
NPI:1932549425
Name:RAD, NAZILA
Entity Type:Individual
Prefix:
First Name:NAZILA
Middle Name:
Last Name:RAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 LOMITA BLVD
Mailing Address - Street 2:STE 302
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-1919
Mailing Address - Country:US
Mailing Address - Phone:424-383-1045
Mailing Address - Fax:424-383-1046
Practice Address - Street 1:3655 LOMITA BLVD STE 302
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-1919
Practice Address - Country:US
Practice Address - Phone:424-383-1045
Practice Address - Fax:424-383-1046
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1418102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology