Healthcare Provider Details

I. General information

NPI: 1972428092
Provider Name (Legal Business Name): SMALL WORLD MED CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8530 WILSHIRE BLVD STE 440
BEVERLY HILLS CA
90211-3115
US

IV. Provider business mailing address

411 E HUNTINGTON DR STE 107-624
ARCADIA CA
91006-3731
US

V. Phone/Fax

Practice location:
  • Phone: 408-832-3188
  • Fax:
Mailing address:
  • Phone: 408-832-3188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. AMIT BANERJEE
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 408-832-3188