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General NPI Number Information
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NPI Number | 1730821935
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Entity Type | Organization
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Legal Business Name | COSMOPOLITAN MEDICAL SPA INC
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 6125 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-4503
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Country | US
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Telephone | 323-723-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 6125 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-4503
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Country | US
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Telephone | 323-723-5656
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Fax |
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | MEELAD MOHAMMADI
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Credential | M.D
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Telephone | 323-674-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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