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General NPI Number Information
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NPI Number | 1245609627
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Entity Type | Organization
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Legal Business Name | DR. NEEVON C. ESMAILI, MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 11400 W OLYMPIC BLVD STE 660
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City | LOS ANGELES
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State | CA
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Zip | 90064-1679
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Country | US
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Telephone | 310-935-0032
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Fax | 310-935-0042
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Provider Business Mailing Address
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Address Line | 11400 W OLYMPIC BLVD STE 660
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City | LOS ANGELES
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State | CA
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Zip | 90064-1679
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Country | US
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Telephone | 310-935-0032
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Fax | 310-935-0042
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEEVON CARL ESMAILI
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Credential | MD
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Telephone | 310-935-0032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A115518
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License Number State | CA
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