Provider Demographics
NPI:1174573588
Name:SOLEIMANI, TOURAGE (MD)
Entity type:Individual
Prefix:
First Name:TOURAGE
Middle Name:
Last Name:SOLEIMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2189
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213
Mailing Address - Country:US
Mailing Address - Phone:310-277-7707
Mailing Address - Fax:310-788-8477
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE 1405
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067
Practice Address - Country:US
Practice Address - Phone:310-277-7707
Practice Address - Fax:310-788-8477
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35797207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A357970Medicaid
CA00A357970Medicaid
CAA35797Medicare ID - Type Unspecified