=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033076450
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORMERON, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2026
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9301 WILSHIRE BLVD STE 401
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90210-6133
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-274-3481
-----------------------------------------------------
Fax | 310-274-3482
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9301 WILSHIRE BLVD STE 401
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90210-6133
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-274-3481
-----------------------------------------------------
Fax | 310-274-3482
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | SHIVA REBECCA GOLSHANI
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 310-367-6763
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------