Healthcare Provider Details

I. General information

NPI: 1558693531
Provider Name (Legal Business Name): PS HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8815 W PICO BLVD
LOS ANGELES CA
90035-3301
US

IV. Provider business mailing address

PO BOX 49879
LOS ANGELES CA
90049-0879
US

V. Phone/Fax

Practice location:
  • Phone: 323-938-9999
  • Fax: 323-456-0880
Mailing address:
  • Phone: 323-938-9999
  • Fax: 323-456-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: PAYAM SHADI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 323-456-0881