Provider Information for 1225348030
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PARDIS GHANDHARI
Sex: Female
NPI: 1225348030
Last Updated: 2024-11-12
Certification Date: 2024-11-12
Certification Date: 2024-11-12
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1225348030 | ||||||||||||||||
| Enumeration Date | 2010-10-14 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 17849 MARGATE ST APT 102 ENCINO, CA 91316-3215 United States Phone: 818-300-4182 | Fax: | ||||||||||||||||
| Primary Practice Address | 17849 MARGATE ST APT 102 ENCINO, CA 91316-3215 United States Phone: 818-300-4182 | Fax: | ||||||||||||||||
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