DR. MOHSEN TANBAKOOCHI MOGHADDAM M.D. NPI 1720010234

NPI Information

NPI: 1720010234
Provider Name: DR. MOHSEN TANBAKOOCHI MOGHADDAM, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
19100 VENTURA BLVD STE 16
TARZANA, CA
ZIP 91356
Phone: (818) 609-1314
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DR. Mohsen Tanbakoochi Moghaddam, M.D. is a general practice in Tarzana, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Mohsen Tanbakoochi Moghaddam, M.D. NPI is 1720010234. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

19100 VENTURA BLVD STE 16
TARZANA, CA
ZIP 91356-234
Phone: (818) 609-1314
Fax: (818) 609-0841

The enumeration date for this NPI number is 7/7/2006 and was last updated on 5/29/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Y00000X	Otolaryngology		A46373	CALIFORNIA	No
2	2081P2900X	Physical Medicine & Rehabilitation	Pain Medicine	A46373	CALIFORNIA	No
3	208D00000X	General Practice		A46373	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A46373	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE
2	E60827	MEDICARE UPIN	CALIFORNIA
3	00A463732	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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