Healthcare Provider Details

I. General information

NPI: 1265449979
Provider Name (Legal Business Name): PARIVASH KASHANI OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 UCLA MEDICAL PLZ STE 305
LOS ANGELES CA
90024-6999
US

IV. Provider business mailing address

10525 TENNESSEE AVE
LOS ANGELES CA
90064-2327
US

V. Phone/Fax

Practice location:
  • Phone: 310-824-3499
  • Fax: 310-824-5190
Mailing address:
  • Phone: 310-824-3499
  • Fax: 310-824-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number2566
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: