=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346545803
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE CONTROL CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2011
-----------------------------------------------------
Last Update Date | 02/17/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9777 WILSHIRE BLVD SUITE #704
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90212-1910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-271-8700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9777 WILSHIRE BLVD SUITE #704
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90212-1910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-271-8700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | REEF KARIM
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 310-625-7333
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TP0016X
-----------------------------------------------------
Taxonomy Name | Prescribing (Medical) Psychologist
-----------------------------------------------------
License Number | CA20A7151
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------