Healthcare Provider Details

I. General information

NPI: 1437221611
Provider Name (Legal Business Name): NIMMI SINGH KAPOOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NIMMI ARORA M.D.

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15503 VENTURA BLVD STE 150
ENCINO CA
91436-3115
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 818-783-0004
  • Fax:
Mailing address:
  • Phone: 310-301-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberA116258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: