Simona Davoudpour DO A Professional Medical Corporation
Family Medicine, Adult Medicine in Los Angeles, CA. Organization (NPI-2).
NPI number1346712866
StatusActive
Last updated in NPPESDec 21, 2018
Details
- NPI
- 1346712866
- Entity type
- Organization (NPI-2)
- Legal business name
- Simona Davoudpour DO A Professional Medical Corporation
- Organization subpart
- No
- Enumeration date
- Dec 21, 2018
- Last updated
- Dec 21, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0505X | Family Medicine, Adult Medicine | – | – | Yes |
Other names
- Platinum Physicians Group (Doing Business As)
Practice location
5757 Wilshire Blvd.Promenade 2
Los Angeles, CA 90036
Phone 424-284-9027
Mailing address
1270 S Alfred St Unit 351614Los Angeles, CA 90035-8066
Authorized official
Simona Davoudpour
President
4242849027
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