Healthcare Provider Details

I. General information

NPI: 1295888915
Provider Name (Legal Business Name): MICHAEL MEHRAN HAYAVI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9025 WILSHIRE BLVD STE 202
BEVERLY HILLS CA
90211-1825
US

IV. Provider business mailing address

PO BOX 108
BEVERLY HILLS CA
90213-0108
US

V. Phone/Fax

Practice location:
  • Phone: 310-888-0086
  • Fax: 866-586-9678
Mailing address:
  • Phone: 310-975-1885
  • Fax: 866-586-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG77704
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: