Healthcare Provider Details

I. General information

NPI: 1386574150
Provider Name (Legal Business Name): PACIFIC CREST HEALTH INDEPENDENT PROVIDER ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 WILSHIRE BLVD STE 600
BEVERLY HILLS CA
90210-6160
US

IV. Provider business mailing address

9301 WILSHIRE BLVD STE 600
BEVERLY HILLS CA
90210-6160
US

V. Phone/Fax

Practice location:
  • Phone: 833-724-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. ROD AMIRI
Title or Position: CEO
Credential: MD
Phone: 310-247-8160