MEDICARE: KAVANAH HEALTH CARE LLC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1225839525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAVANAH HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	15910 VENTURA BLVD STE 1701
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2816
Country	:	US
Telephone Number	:	310-616-5188
Fax Number	:	310-616-5188

Provider Business Practice Location Address
First Line	:	6100 OAK TREE BLVD
Second Line	:
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2544
Country	:	US
Telephone Number	:	310-933-5688
Fax Number	:	310-616-5188

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MICHAEL FARAH
Credential	:
Telephone Number	:	310-879-7167

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	05/12/2026

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