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NPI Code Detail

MEDICARE: HALEH BAKSHANDEH MD

MEDICARE: HALEH BAKSHANDEH 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
1207N00000XDermatology PhysicianME87453FL
2207N00000XDermatology PhysicianA89344CA

General Provider Information

NPI Number : 1770684219
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEH BAKSHANDEH MD
Provider Business Mailing Address
First Line : 9730 WILSHIRE BLVD
Second Line : SUITE 115
City : BEVERLY HILLS
State : CA
Zip : 90212-2022
Country : US
Telephone Number : 310-274-7623
Fax Number : 310-274-1032
Provider Business Practice Location Address
First Line : 9730 WILSHIRE BLVD
Second Line : SUITE 115
City : BEVERLY HILLS
State : CA
Zip : 90212-2022
Country : US
Telephone Number : 310-274-7623
Fax Number : 310-274-1032
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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Directions to “ HALEH BAKSHANDEH MD” Practice Location

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