Healthcare Provider Details

I. General information

NPI: 1023959574
Provider Name (Legal Business Name): POUYAN FAMINI, M.D., A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16661 VENTURA BLVD STE 818
ENCINO CA
91436-1999
US

IV. Provider business mailing address

16661 VENTURA BLVD STE 818
ENCINO CA
91436-1999
US

V. Phone/Fax

Practice location:
  • Phone: 818-501-3320
  • Fax: 818-501-3414
Mailing address:
  • Phone: 818-501-3320
  • Fax: 818-501-3414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. POUYAN FAMINI
Title or Position: PRESIDENT
Credential: MD
Phone: 818-605-6711