Healthcare Provider Details

I. General information

NPI: 1952560815
Provider Name (Legal Business Name): MICHELLE RUTH YASHARPOUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. MICHELLE RUTH YADEGARI

II. Dates (important events)

Enumeration Date: 06/05/2008
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 NumberA106481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: