Healthcare Provider Details

I. General information

NPI: 1750917738
Provider Name (Legal Business Name): RAMIN BADIYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11620 WILSHIRE BLVD STE 600
LOS ANGELES CA
90025-1776
US

IV. Provider business mailing address

11620 WILSHIRE BLVD STE 600
LOS ANGELES CA
90025-1776
US

V. Phone/Fax

Practice location:
  • Phone: 310-876-2405
  • Fax: 310-469-9708
Mailing address:
  • Phone: 310-876-2405
  • Fax: 310-469-9708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number184210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: