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General NPI Number Information
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NPI Number | 1154819126
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Entity Type | Organization
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Legal Business Name | WESTERN INSTITUTE OF CRITICAL CARE MEDICINE, INC
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 800 S MAIN ST
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City | CORONA
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State | CA
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Zip | 92882-3420
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Country | US
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Telephone | 951-737-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 92 ASHDALE
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City | IRVINE
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State | CA
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Zip | 92620-7311
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Country | US
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Telephone | 804-306-9494
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAMIN AKHAVAN
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Credential | MD
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Telephone | 804-306-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number |
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License Number State | CA
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