Provider Demographics
NPI:1770554933
Name:RAMAZANKHANI, REZA (MD)
Entity type:Individual
Prefix:DR
First Name:REZA
Middle Name:
Last Name:RAMAZANKHANI
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 1:1215 ARMACOST AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1443
Mailing Address - Country:US
Mailing Address - Phone:858-525-1963
Mailing Address - Fax:877-852-5845
Practice Address - Street 1:1215 ARMACOST AVE APT 202
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1443
Practice Address - Country:US
Practice Address - Phone:858-525-1963
Practice Address - Fax:877-852-5845
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37501207L00000X
CAA77800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology