Healthcare Provider Details

I. General information

NPI: 1437100278
Provider Name (Legal Business Name): NIMA A FAHIMIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12381 WILSHIRE BLVD STE 205
LOS ANGELES CA
90025-1063
US

IV. Provider business mailing address

12381 WILSHIRE BLVD STE 205
LOS ANGELES CA
90025-1063
US

V. Phone/Fax

Practice location:
  • Phone: 310-990-6507
  • Fax: 424-238-3030
Mailing address:
  • Phone: 310-990-6507
  • Fax: 424-238-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberA85986
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: