Healthcare Provider Details

I. General information

NPI: 1518706241
Provider Name (Legal Business Name): BEHNAM HEKMATNIA L.AC. (LICENSED ACUP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 05/22/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 VAN NUYS BLVD. SUITE 212
PANORAMA CITY CA
91402-4834
US

IV. Provider business mailing address

8215 VAN NUYS BLVD. SUITE 212
PANORAMA CITY CA
91402-4834
US

V. Phone/Fax

Practice location:
  • Phone: 310-272-0150
  • Fax: 818-902-9119
Mailing address:
  • Phone: 310-272-0150
  • Fax: 818-902-9119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC-16410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: