Basic Information
| Provider Information | |||||||||
| NPI: | 1366466757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SADRIEH | ||||||||
| FirstName: | KIARASH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1701 E CESAR E CHAVEZ AVE | ||||||||
| Address2: | SUITE 532 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900332464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3239871200 | ||||||||
| FaxNumber: | 3239871212 | ||||||||
| Practice Location | |||||||||
| Address1: | 1701 E CESAR E CHAVEZ AVE | ||||||||
| Address2: | SUITE 532 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900332464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3239871200 | ||||||||
| FaxNumber: | 3239871212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 12/04/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0402X | A83153 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology |
No ID Information.