Provider Demographics
NPI:1679881346
Name:NIAMEHR, NOURIEL (DO)
Entity type:Individual
Prefix:
First Name:NOURIEL
Middle Name:
Last Name:NIAMEHR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:224 N FAIR OAKS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3618
Mailing Address - Country:US
Mailing Address - Phone:626-696-1400
Mailing Address - Fax:626-696-1450
Practice Address - Street 1:14600 SHERMAN WAY STE 250
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2284
Practice Address - Country:US
Practice Address - Phone:818-212-2223
Practice Address - Fax:818-212-2224
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY253051208100000X
CA20A11311208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation