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General NPI Number Information
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NPI Number | 1023595170
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Entity Type | Organization
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Legal Business Name | PREMIER POINT MEDICAL GROUP
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Dates
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Enumeration Date | 07/22/2018
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Last Update Date | 07/22/2018
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Provider Practice Location Address
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Address Line | 11819 WILSHIRE BLVD STE 208
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City | LOS ANGELES
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State | CA
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Zip | 90025-6631
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Country | US
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Telephone | 714-507-8600
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Fax | 310-478-5850
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Provider Business Mailing Address
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Address Line | 11819 WILSHIRE BLVD STE 208
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City | LOS ANGELES
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State | CA
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Zip | 90025-6631
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Country | US
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Telephone | 714-507-8600
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Fax | 310-478-5850
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. MOHSEN BADRI
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Credential | MD, DO, MPH
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Telephone | 310-497-1024
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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 | 20A9095
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License Number State | CA
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