MEDICARE: DR. MICHAEL MEHRAN HAYAVI M.D.

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	207L00000X	Anesthesiology Physician	G77704	CA

General Provider Information

NPI Number	:	1295888915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL MEHRAN HAYAVI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 108
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90213-0108
Country	:	US
Telephone Number	:	310-975-1885
Fax Number	:	866-586-9678

Provider Business Practice Location Address
First Line	:	9025 WILSHIRE BLVD STE 202
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1825
Country	:	US
Telephone Number	:	310-888-0086
Fax Number	:	866-586-9678

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

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	03/07/2023

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