Healthcare Provider Details

I. General information

NPI: 1649792714
Provider Name (Legal Business Name): MICHAEL HAKIMI, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2017
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 N LINDEN DR STE 333
BEVERLY HILLS CA
90212-2449
US

IV. Provider business mailing address

10787 WILSHIRE BLVD APT 1203
LOS ANGELES CA
90024-7341
US

V. Phone/Fax

Practice location:
  • Phone: 424-239-5201
  • Fax: 424-239-5204
Mailing address:
  • Phone: 310-428-7370
  • Fax: 424-239-5204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA113583
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL HAKIMI
Title or Position: PRESIDENT / CEO
Credential: MD
Phone: 626-796-3700