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General NPI Number Information
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NPI Number | 1487600532
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS HEALTH CARE GROUP INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 1125 S BEVERLY DR SUITE 400
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City | LOS ANGELES
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State | CA
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Zip | 90035-1148
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Country | US
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Telephone | 310-880-1110
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Fax | 310-282-9955
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Provider Business Mailing Address
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Address Line | 1125 S BEVERLY DR SUITE 400
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City | LOS ANGELES
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State | CA
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Zip | 90035-1148
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Country | US
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Telephone | 310-880-1110
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Fax | 310-282-9955
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Authorized Official
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Title or Position | ONWER/PRESIDENT
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Name | DR. FARID JAVEDANFAR
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Credential | M.D.
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Telephone | 310-990-9822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A76858
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License Number State | CA
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