Provider Demographics
NPI:1043434012
Name:FOWROOZ JOOLHAR M.D. A MEDICAL CORP
Entity type:Organization
Organization Name:FOWROOZ JOOLHAR M.D. A MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FOWROOZ
Authorized Official - Middle Name:
Authorized Official - Last Name:JOOLHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-552-5010
Mailing Address - Street 1:PO BOX 1557
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1557
Mailing Address - Country:US
Mailing Address - Phone:818-552-5010
Mailing Address - Fax:818-552-5020
Practice Address - Street 1:1510 S CENTRAL AVE
Practice Address - Street 2:SUITE 650
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2500
Practice Address - Country:US
Practice Address - Phone:818-552-5010
Practice Address - Fax:818-552-5020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55067207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty