Healthcare Provider Details

I. General information

NPI: 1881840353
Provider Name (Legal Business Name): NAVID HAKIMIAN MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 S SEPULVEDA BLVD SUITE 1111
LOS ANGELES CA
90045-3807
US

IV. Provider business mailing address

PO BOX 91765
LOS ANGELES CA
90009-1765
US

V. Phone/Fax

Practice location:
  • Phone: 310-645-3029
  • Fax: 310-645-8685
Mailing address:
  • Phone: 310-645-3029
  • Fax: 310-645-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG70719
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG70719
License Number StateCA

VIII. Authorized Official

Name: DR. NAVID HAKIMIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-645-3029