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General NPI Number Information
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NPI Number | 1881562338
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Entity Type | Organization
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Legal Business Name | JRPB MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 6222 W MANCHESTER AVE STE A
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City | LOS ANGELES
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State | CA
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Zip | 90045-3801
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Country | US
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Telephone | 310-670-1840
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Fax | 310-670-4016
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Provider Business Mailing Address
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Address Line | 6222 W MANCHESTER AVE STE A
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City | LOS ANGELES
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State | CA
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Zip | 90045-3801
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Country | US
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Telephone | 310-670-1840
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Fax | 310-670-4016
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | PAYMON BANAFSHE
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Credential | DO
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Telephone | 310-670-1840
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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 |
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License Number State |
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