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General NPI Number Information
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NPI Number | 1750061149
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Entity Type | Organization
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Legal Business Name | ARC-LINE MEDICAL , INC.
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD STE 510
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City | LOS ANGELES
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State | CA
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Zip | 90017-3906
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Country | US
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Telephone | 310-620-2727
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Fax | 310-620-2726
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Provider Business Mailing Address
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Address Line | 9662 SANTA MONICA BLVD #882
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City | BEVERLY HILS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 310-620-2727
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. PEYMAN GRAVORI
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Credential | DO
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Telephone | 310-620-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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