MEDICARE: LUX MEDICAL SERVICES

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
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1659136547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUX MEDICAL SERVICES

Provider Business Mailing Address
First Line	:	11750 WILSHIRE BLVD APT 1401
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6993
Country	:	US
Telephone Number	:	888-200-6041
Fax Number	:	702-447-6464

Provider Business Practice Location Address
First Line	:	4471 DEAN MARTIN DR UNIT 2710
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4245
Country	:	US
Telephone Number	:	888-200-6041
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FARNOOSH KARGARZADEH
Credential	:
Telephone Number	:	720-270-7859

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	08/05/2025

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Directions to “LUX MEDICAL SERVICES ” Practice Location

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