MEDICARE: ROBERT BABAK HASHEMIYOON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G86202	CA

General Provider Information

NPI Number	:	1205903762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT BABAK HASHEMIYOON MD

Provider Business Mailing Address
First Line	:	17525 VENTURA BLVD STE 203
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-5109
Country	:	US
Telephone Number	:	310-271-5875
Fax Number	:	818-387-6804

Provider Business Practice Location Address
First Line	:	17525 VENTURA BLVD STE 203
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-5109
Country	:	US
Telephone Number	:	310-271-5875
Fax Number	:	818-387-6804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	11/19/2021

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