Healthcare Provider Details

I. General information

NPI: 1992240097
Provider Name (Legal Business Name): LEILA MUSAVI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2016
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 N CAMDEN DR STE 500
BEVERLY HILLS CA
90210-4443
US

IV. Provider business mailing address

433 N CAMDEN DR STE 500
BEVERLY HILLS CA
90210-4443
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-5582
  • Fax:
Mailing address:
  • Phone: 310-825-5582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA179039
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: