Aviccenna Medical Group
Internal Medicine, Nephrology in Beverly Hills, CA. Organization (NPI-2).
NPI number1124264635
StatusActive
Last updated in NPPESJul 1, 2009
Details
- NPI
- 1124264635
- Entity type
- Organization (NPI-2)
- Legal business name
- Aviccenna Medical Group
- Organization subpart
- No
- Enumeration date
- Jan 5, 2009
- Last updated
- Jul 1, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RN0300X | Internal Medicine, Nephrology | A100198 | CA | Yes |
Practice location
435 N Bedford DrSuite # 312
Beverly Hills, CA 90210-4321
Phone 310-858-1800
Mailing address
3392 Motor AveLos Angeles, CA 90034-3712
Phone 310-858-1800
Authorized official
Seyed Farhad N Chimeh
President
3108581800
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