Healthcare Provider Details

I. General information

NPI: 1023459302
Provider Name (Legal Business Name): KOOROSH J ELIHU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N DOHENY DR
BEVERLY HILLS CA
90211-1621
US

IV. Provider business mailing address

PO BOX 15742
BEVERLY HILLS CA
90209-1742
US

V. Phone/Fax

Practice location:
  • Phone: 213-340-6505
  • Fax:
Mailing address:
  • Phone: 310-497-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA133689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: