Healthcare Provider Details

I. General information

NPI: 1992816631
Provider Name (Legal Business Name): RAMIN EBRAHIMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 UCLA MEDICAL PLAZA SUITE #770
LOS ANGELES CA
90024
US

IV. Provider business mailing address

801 N TIGERTAIL ROAD
LOS ANGELES CA
90049
US

V. Phone/Fax

Practice location:
  • Phone: 310-824-7707
  • Fax: 310-268-4178
Mailing address:
  • Phone: 310-824-7707
  • Fax: 310-268-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG065016
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG065016
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberG065016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: