Healthcare Provider Details

I. General information

NPI: 1851882955
Provider Name (Legal Business Name): MICHELLE YASHARPOUR MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N ROBERTSON BLVD STE 307
BEVERLY HILLS CA
90211-2145
US

IV. Provider business mailing address

8549 WILSHIRE BLVD STE 1426
BEVERLY HILLS CA
90211-3104
US

V. Phone/Fax

Practice location:
  • Phone: 310-285-6650
  • Fax: 866-285-1590
Mailing address:
  • Phone: 310-285-6650
  • Fax: 866-285-1590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE RUTH YASHARPOUR
Title or Position: OWNER
Credential: MD
Phone: 310-285-6650