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General NPI Number Information
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NPI Number | 1659830545
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Entity Type | Individual
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Provider Name | BENJAMIN ROSTAMI MD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 1080 N WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90029
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Country | US
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Telephone | 310-963-3035
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Fax |
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Provider Business Mailing Address
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Address Line | 719 N ROXBURY DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-3211
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Country | US
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Telephone | 310-963-3035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A176597
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License Number State | CA
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