Healthcare Provider Details

I. General information

NPI: 1114186608
Provider Name (Legal Business Name): DELIGHT MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8484 WILSHIRE BLVD SUITE 670
BEVERLY HILLS CA
90211-3227
US

IV. Provider business mailing address

8484 WILSHIRE BLVD SUITE 670
BEVERLY HILLS CA
90211-3227
US

V. Phone/Fax

Practice location:
  • Phone: 310-859-1077
  • Fax: 323-782-9432
Mailing address:
  • Phone: 310-859-1077
  • Fax: 323-782-9432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number20A8382
License Number StateCA

VIII. Authorized Official

Name: PAYAM KERENDIAN
Title or Position: MEDICAL DIRECTOR
Credential: D.O.
Phone: 310-859-1077