Healthcare Provider Details

I. General information

NPI: 1699955179
Provider Name (Legal Business Name): SHERWIN RAMON HARIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2007
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S LA CIENEGA BLVD STE 101
BEVERLY HILLS CA
90211-3313
US

IV. Provider business mailing address

240 S LA CIENEGA BLVD STE 101
BEVERLY HILLS CA
90211-3313
US

V. Phone/Fax

Practice location:
  • Phone: 310-855-9909
  • Fax:
Mailing address:
  • Phone: 310-855-9909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberA108924
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberA108924
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: