Healthcare Provider Details

I. General information

NPI: 1003721663
Provider Name (Legal Business Name): COSMETIQUE SURGICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10744 WASHINGTON BLVD
CULVER CITY CA
90232
US

IV. Provider business mailing address

10744 WASHINGTON BLVD
CULVER CITY CA
90232
US

V. Phone/Fax

Practice location:
  • Phone: 310-837-5555
  • Fax: 424-326-0276
Mailing address:
  • Phone: 310-837-5555
  • Fax: 424-326-0276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAMIN SARSHAD
Title or Position: OWNER
Credential: MD
Phone: 310-837-5555