Provider Demographics
NPI:1538384797
Name:MASSOUDI, RAMTIN T (MD)
Entity type:Individual
Prefix:DR
First Name:RAMTIN
Middle Name:T
Last Name:MASSOUDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16661 VENTURA BLVD STE 824
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4802
Mailing Address - Country:US
Mailing Address - Phone:310-855-7171
Mailing Address - Fax:310-855-7262
Practice Address - Street 1:16661 VENTURA BLVD STE 824
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4802
Practice Address - Country:US
Practice Address - Phone:310-855-7171
Practice Address - Fax:310-855-7262
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2023-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA82557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
W19248Medicare PIN