Healthcare Provider Details

I. General information

NPI: 1346545803
Provider Name (Legal Business Name): THE CONTROL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9777 WILSHIRE BLVD SUITE #704
BEVERLY HILLS CA
90212-1910
US

IV. Provider business mailing address

9777 WILSHIRE BLVD SUITE #704
BEVERLY HILLS CA
90212-1910
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-8700
  • Fax:
Mailing address:
  • Phone: 310-271-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberCA20A7151
License Number StateCA

VIII. Authorized Official

Name: REEF KARIM
Title or Position: OWNER
Credential: D.O.
Phone: 310-625-7333