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NPI Code Detail

MEDICARE: DR. SHOHREH YOUNESSIAN PEDOUIM ACUPUNCTURIST

MEDICARE:  DR. SHOHREH  YOUNESSIAN PEDOUIM  ACUPUNCTURIST
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
1171100000XAcupuncturist9391CA

General Provider Information

NPI Number : 1184953119
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHOHREH YOUNESSIAN PEDOUIM ACUPUNCTURIST
Provider Business Mailing Address
First Line : 145 N ALMONT DR
Second Line : #2
City : BEVERLY HILLS
State : CA
Zip : 90211-1819
Country : US
Telephone Number : 310-205-9114
Fax Number : 310-859-4745
Provider Business Practice Location Address
First Line : 4201 WILSHIRE BLVD
Second Line : STE. 515
City : LOS ANGELES
State : CA
Zip : 90010-3601
Country : US
Telephone Number : 310-205-9114
Fax Number : 310-859-4745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2009
Last Update Date : 12/22/2009

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Directions to “ DR. SHOHREH YOUNESSIAN PEDOUIM ACUPUNCTURIST” Practice Location

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