Healthcare Provider Details

I. General information

NPI: 1043147812
Provider Name (Legal Business Name): PREMIER CARDIOLOGY OF BEVERLY HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 WILSHIRE BLVD STE 420
BEVERLY HILLS CA
90211-2004
US

IV. Provider business mailing address

8920 WILSHIRE BLVD STE 420
BEVERLY HILLS CA
90211-2004
US

V. Phone/Fax

Practice location:
  • Phone: 310-652-5210
  • Fax: 310-652-5211
Mailing address:
  • Phone: 310-652-5210
  • Fax: 310-652-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN A DANESHRAD
Title or Position: PRESIDENT
Credential: MD
Phone: 310-880-7042