MEDICARE: KASRA SEDARATI M.D. INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
2	207RP1001X	Pulmonary Disease Physician
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1063079176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KASRA SEDARATI M.D. INC.

Provider Business Mailing Address
First Line	:	325 N MAPLE DR UNIT 1863
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90213-4754
Country	:	US
Telephone Number	:	424-249-9408
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 N MAPLE DR UNIT 1863
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90213-4754
Country	:	US
Telephone Number	:	424-249-9408
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. KASRA SEDARATI
Credential	:	M.D.
Telephone Number	:	424-249-9408

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	08/08/2023

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