Provider Demographics
NPI:1053349126
Name:YASHAR, BAHRAM (DO)
Entity type:Individual
Prefix:DR
First Name:BAHRAM
Middle Name:
Last Name:YASHAR
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 MANTON AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3026
Mailing Address - Country:US
Mailing Address - Phone:310-386-6435
Mailing Address - Fax:818-992-4185
Practice Address - Street 1:9808 VENICE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6829
Practice Address - Country:US
Practice Address - Phone:832-604-3771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8818207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine