Healthcare Provider Details

I. General information

NPI: 1427873405
Provider Name (Legal Business Name): PARMIS FAKHERI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 N BEDFORD DR STE 311
BEVERLY HILLS CA
90210-4320
US

IV. Provider business mailing address

436 N BEDFORD DR STE 311
BEVERLY HILLS CA
90210-4320
US

V. Phone/Fax

Practice location:
  • Phone: 310-890-5834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA65427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: