Healthcare Provider Details

I. General information

NPI: 1033324785
Provider Name (Legal Business Name): NAGHMEH KERENDIAN D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 S LA CIENEGA BLVD SUITE 201
BEVERLY HILLS CA
90211-3328
US

IV. Provider business mailing address

8349 BLACKBURN AVE #102
LOS ANGELES CA
90048-4279
US

V. Phone/Fax

Practice location:
  • Phone: 310-721-2643
  • Fax:
Mailing address:
  • Phone: 310-721-2643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License Number20A8544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: