Provider Demographics
NPI:1669749149
Name:ROBERT NARAGHI, MD INC
Entity type:Organization
Organization Name:ROBERT NARAGHI, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:NARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-5551
Mailing Address - Street 1:15332 ANTIOCH ST
Mailing Address - Street 2:#874
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3628
Mailing Address - Country:US
Mailing Address - Phone:213-484-5551
Mailing Address - Fax:213-207-5815
Practice Address - Street 1:2200 W 3RD ST
Practice Address - Street 2:STE 500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1932
Practice Address - Country:US
Practice Address - Phone:213-484-5551
Practice Address - Fax:213-207-5815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83950204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG83950OtherCA LICENSE