Healthcare Provider Details

I. General information

NPI: 1306482310
Provider Name (Legal Business Name): JANUS MANAGEMENT PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8641 WILSHIRE BLVD STE 305
BEVERLY HILLS CA
90211-2921
US

IV. Provider business mailing address

8549 WILSHIRE BLVD STE 1158
BEVERLY HILLS CA
90211-3104
US

V. Phone/Fax

Practice location:
  • Phone: 310-772-2866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: NIMA SHEMIRANI
Title or Position: PRESIDENT
Credential: MD
Phone: 310-772-2866