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General NPI Number Information
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NPI Number | 1104619071
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Entity Type | Organization
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Legal Business Name | PANTEHA PARTOVI PA-C CORP
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 11600 WILSHIRE BLVD STE 322
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City | LOS ANGELES
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State | CA
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Zip | 90025-1783
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Country | US
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Telephone | 310-688-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 11600 WILSHIRE BLVD STE 322
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City | LOS ANGELES
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State | CA
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Zip | 90025-1783
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Country | US
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Telephone | 310-688-8800
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. PANTEHA PARTOVI
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Credential | PA
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Telephone | 310-688-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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