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General NPI Number Information
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NPI Number | 1679378293
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Entity Type | Organization
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Legal Business Name | ELEVATE MIND AND WELLNESS, INC.
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 9100 WILSHIRE BLVD EAST TOWER SUITE 333 #1036
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City | BEVERLY HILLS
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State | CA
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Zip | 90212
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Country | US
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Telephone | 310-425-4558
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Fax | 651-666-1450
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Provider Business Mailing Address
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Address Line | 9100 WILSHIRE BLVD EAST TOWER SUITE 333 #1036
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City | BEVERLY HILLS
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State | CA
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Zip | 90212
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Country | US
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Telephone | 310-425-4558
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Fax | 651-666-1450
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Authorized Official
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Title or Position | OWNER
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Name | DR. YASHA RASTGAR
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Credential | MD
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Telephone | 310-425-3558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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