Provider Demographics
NPI:1295753234
Name:DEMIROZU, MEHMET CUNEYT (MD)
Entity type:Individual
Prefix:MR
First Name:MEHMET
Middle Name:CUNEYT
Last Name:DEMIROZU
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:P.O. BOX 641245
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-6245
Mailing Address - Country:US
Mailing Address - Phone:310-644-9515
Mailing Address - Fax:310-644-3629
Practice Address - Street 1:4477 W 118TH STREET #303
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2258
Practice Address - Country:US
Practice Address - Phone:310-644-9515
Practice Address - Fax:310-644-3629
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52940207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A529400Medicaid
CAG01575Medicare UPIN
CA00A529400Medicaid