Healthcare Provider Details

I. General information

NPI: 1245544931
Provider Name (Legal Business Name): WILSHIRE CRESCENT HEIGHTS MEDICAL CENTER A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 WILSHIRE BLVD STE 625
BEVERLY HILLS CA
90211-3120
US

IV. Provider business mailing address

8500 WILSHIRE BLVD STE 625
BEVERLY HILLS CA
90211-3120
US

V. Phone/Fax

Practice location:
  • Phone: 310-360-9785
  • Fax: 310-360-9889
Mailing address:
  • Phone: 310-360-9785
  • Fax: 310-360-9889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA401920
License Number StateCA

VIII. Authorized Official

Name: DR. MALIHE DARDASHTI
Title or Position: PHYSICIAN
Credential: MD
Phone: 310-360-9785