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General NPI Number Information
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NPI Number | 1386459006
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Entity Type | Organization
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Legal Business Name | AHURA WELLNESS PC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 10921 WILSHIRE BLVD STE 111
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City | LOS ANGELES
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State | CA
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Zip | 90024-3906
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Country | US
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Telephone | 310-273-7365
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 67070
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City | LOS ANGELES
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State | CA
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Zip | 90067-0070
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIMA YAZDANPANAH
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Credential |
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Telephone | 310-273-7365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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