Provider Demographics
NPI:1437966751
Name:KARIMZADEH GHARIEHABAS, ALI
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:KARIMZADEH GHARIEHABAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:KARIMZADEH GHARIEHABAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:21201 KITTRIDGE ST APT 1207
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91303-5002
Mailing Address - Country:US
Mailing Address - Phone:818-298-2273
Mailing Address - Fax:
Practice Address - Street 1:SLAMIC AZAD UNIVERSITY CENTRAL ORGANIZATION NO. 5, HASH
Practice Address - Street 2:
Practice Address - City:THERAN
Practice Address - State:TEHRAN
Practice Address - Zip Code:1591633411
Practice Address - Country:IR
Practice Address - Phone:982-148-6640
Practice Address - Fax:982-148-6640
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-248611163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergencyGroup - Single Specialty