1215318423 NPI number — RAYMOND NOURMAND, PH.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215318423 NPI number — RAYMOND NOURMAND, PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAYMOND NOURMAND, PH.D.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215318423
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11911 SAN VICENTE BLVD
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90049-5086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-963-4007
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11911 SAN VICENTE BLVD
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90049-5086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-963-4007
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NOURMAND
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
SALAR
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
310-963-4007

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY 26470 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)