MEDICARE: BRAIN HEALTH IPA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1033047055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAIN HEALTH IPA INC

Provider Business Mailing Address
First Line	:	4319 SEPULVEDA BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4715
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4319 SEPULVEDA BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4715
Country	:	US
Telephone Number	:	877-515-8113
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EHAB YACOUB
Credential	:	MD
Telephone Number	:	877-515-8113

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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Directions to “BRAIN HEALTH IPA INC ” Practice Location

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