Healthcare Provider Details

I. General information

NPI: 1427939883
Provider Name (Legal Business Name): PARTOVI PHYSICIAN ASSISTANT PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 WILSHIRE BLVD STE 322
LOS ANGELES CA
90025-1783
US

IV. Provider business mailing address

11600 WILSHIRE BLVD STE 322
LOS ANGELES CA
90025-1783
US

V. Phone/Fax

Practice location:
  • Phone: 310-600-7078
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. PANTEHA PARTOVI
Title or Position: PA/OWNER
Credential: PA
Phone: 310-600-7078