Healthcare Provider Details

I. General information

NPI: 1609133586
Provider Name (Legal Business Name): FERAS YAMIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 WILSHIRE BLVD STE 102
BEVERLY HILLS CA
90211-1950
US

IV. Provider business mailing address

9701 WILSHIRE BLVD
BEVERLY HILLS CA
90212-2020
US

V. Phone/Fax

Practice location:
  • Phone: 424-235-5157
  • Fax:
Mailing address:
  • Phone: 310-598-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberA132061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: