Provider Demographics
NPI:1881334902
Name:JALILI, MOHAMMAD H (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:H
Last Name:JALILI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD HOSSEIN
Other - Middle Name:
Other - Last Name:JALILI BAHABADI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:757 WESTWOOD PLZAZA (SURGERY)
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7419
Mailing Address - Country:US
Mailing Address - Phone:310-206-9291
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ # SURGERY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7419
Practice Address - Country:US
Practice Address - Phone:310-206-9291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program