Healthcare Provider Details

I. General information

NPI: 1083061238
Provider Name (Legal Business Name): NEIL MENELAOS VRANIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 N CAMDEN DR STE 780
BEVERLY HILLS CA
90210-4406
US

IV. Provider business mailing address

433 N CAMDEN DR STE 780
BEVERLY HILLS CA
90210-4406
US

V. Phone/Fax

Practice location:
  • Phone: 310-275-1959
  • Fax: 310-299-8646
Mailing address:
  • Phone: 310-275-1959
  • Fax: 310-299-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA175234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: