Healthcare Provider Details

I. General information

NPI: 1518705771
Provider Name (Legal Business Name): SUPPORTIVE CARE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
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 STE 242
LOS ANGELES CA
90035-1403
US

V. Phone/Fax

Practice location:
  • Phone: 626-765-4302
  • Fax: 310-657-8728
Mailing address:
  • Phone: 626-765-4302
  • Fax: 310-657-8728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SHAHRIAR JARCHI
Title or Position: OWNER/ PRESIDENT
Credential: MD
Phone: 626-765-4302