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General NPI Number Information
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NPI Number | 1679166623
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Entity Type | Organization
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Legal Business Name | STEM CELL & PRP INSTITUTE OF LA GENERAL & MENS HEALTH PAIN & AEST
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST # 545E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 323-207-6334
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Fax |
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Provider Business Mailing Address
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Address Line | 8631 W 3RD ST # 545E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 323-207-6334
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PADRA NOURPARVAR
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Credential | DO
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Telephone | 323-207-6334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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