Healthcare Provider Details

I. General information

NPI: 1992744874
Provider Name (Legal Business Name): RAMIN MIRHASHEMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23600 TELO AVE SUITE 250
TORRANCE CA
90505-4035
US

IV. Provider business mailing address

351 HOSPITAL RD SUITE 507
NEWPORT BEACH CA
92663-3509
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-8446
  • Fax: 310-375-8489
Mailing address:
  • Phone: 949-642-1361
  • Fax: 949-642-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberG86713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: