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General NPI Number Information
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NPI Number | 1013521137
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Entity Type | Organization
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Legal Business Name | RONAK KAVIAN MD INC
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Dates
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Enumeration Date | 09/04/2020
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 5901 W OLYMPIC BLVD STE 504
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City | LOS ANGELES
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State | CA
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Zip | 90036-4633
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Country | US
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Telephone | 310-801-4706
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Fax |
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Provider Business Mailing Address
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Address Line | 640 HERMOSA AVE
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-4441
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Country | US
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Telephone | 310-801-4706
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | DR. RONAK KAVIAN
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Credential | MD MPH
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Telephone | 310-801-4706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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