Healthcare Provider Details

I. General information

NPI: 1063566842
Provider Name (Legal Business Name): ARASTOU AMINZADEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 S LA CIENEGA BLVD SUITE 210
BEVERLY HILLS CA
90211-3328
US

IV. Provider business mailing address

PO BOX 11229
BEVERLY HILLS CA
90213-4229
US

V. Phone/Fax

Practice location:
  • Phone: 310-691-5005
  • Fax: 310-691-5236
Mailing address:
  • Phone: 310-691-5005
  • Fax: 310-691-5236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA92270
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberA92270
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA92270
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: