Healthcare Provider Details

I. General information

NPI: 1588233654
Provider Name (Legal Business Name): ELEVATION MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 09/02/2025
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 S ROBERTSON BLVD STE 242
LOS ANGELES CA
90035-1403
US

IV. Provider business mailing address

1171 S ROBERTSON BLVD
LOS ANGELES CA
90035-1403
US

V. Phone/Fax

Practice location:
  • Phone: 626-442-5200
  • Fax:
Mailing address:
  • Phone: 626-765-4302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAHRIAR JARCHI
Title or Position: PRESIDENT
Credential: MD
Phone: 626-765-4321