=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518109750
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL HAKIMI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2009
-----------------------------------------------------
Last Update Date | 07/31/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 462 N LINDEN DR STE 333
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90212-2449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-239-5201
-----------------------------------------------------
Fax | 424-239-5204
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10787 WILSHIRE BLVD APT 1203
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90024-7341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-428-7370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | A113583
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------