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General NPI Number Information
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NPI Number | 1023969227
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Entity Type | Individual
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Provider Name | MARIAM KHALATIAN
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Gender | Female
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 433 N CAMDEN DR STE 950
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-1913
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Country | US
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Telephone | 424-377-2220
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Fax | 424-600-8273
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Provider Business Mailing Address
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Address Line | 10656 ALDEA AVE
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City | GRANADA HILLS
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State | CA
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Zip | 91344-6133
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Country | US
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Telephone | 818-434-4374
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Fax | 818-434-4374
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95038423
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License Number State | CA
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