Healthcare Provider Details

I. General information

NPI: 1407765233
Provider Name (Legal Business Name): MICHAEL PIMIENTA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 WILSHIRE BLVD STE 200
LOS ANGELES CA
90048-5724
US

IV. Provider business mailing address

15260 VENTURA BLVD STE 1060
SHERMAN OAKS CA
91403-5327
US

V. Phone/Fax

Practice location:
  • Phone: 818-515-4717
  • Fax:
Mailing address:
  • Phone: 818-515-4717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MICHAEL PIMIENTA
Title or Position: PRESIDENT
Credential: MD
Phone: 818-515-4717