Healthcare Provider Details

I. General information

NPI: 1063211662
Provider Name (Legal Business Name): BRIAN AMINPOUR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2326 WARM SPRINGS RD
COLUMBUS GA
31904-6860
US

IV. Provider business mailing address

704 N CAMDEN DR
BEVERLY HILLS CA
90210-3205
US

V. Phone/Fax

Practice location:
  • Phone: 706-324-1415
  • Fax:
Mailing address:
  • Phone: 310-869-4162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: