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General NPI Number Information
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NPI Number | 1164776340
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Entity Type | Organization
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Legal Business Name | ALLEN KAMRAVA, MD MBA INC.
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 435 N BEDFORD DR STE 308
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4380
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Country | US
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Telephone | 424-279-8222
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Fax | 424-279-8226
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Provider Business Mailing Address
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Address Line | 435 N BEDFORD DR STE 308
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4380
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Country | US
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Telephone | 424-279-8222
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Fax | 424-279-8226
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLEN KAMRAVA
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Credential | M.D.
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Telephone | 424-279-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A103694
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License Number State | CA
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