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Siamak Etehad, MD, INC. A Medical Corporation

Internal Medicine in Northridge, CA. Organization (NPI-2).

NPI number1730516303
StatusActive
Last updated in NPPESSep 27, 2013

Details

NPI
1730516303
Entity type
Organization (NPI-2)
Legal business name
Siamak Etehad, MD, INC. A Medical Corporation
Organization subpart
No
Enumeration date
Sep 27, 2013
Last updated
Sep 27, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineA43714CAYes

Practice location

17075 Devonshire St Ste 100
Northridge, CA 91325-5405

Phone 800-673-8185 · Fax 310-626-9765

Mailing address

Po Box 280636
Northridge, CA 91328-0636

Phone 800-673-8185

Authorized official

Siamak Pour Etehad
President
8006738185

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