MEDICARE: DR. KIARASH NMN MICHEL M.D.

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	208800000X	Urology Physician	G81612	CA

General Provider Information

NPI Number	:	1255390464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIARASH NMN MICHEL M.D.

Provider Business Mailing Address
First Line	:	8631 W 3RD ST
Second Line	:	1115 EAST
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5901
Country	:	US
Telephone Number	:	310-278-8330
Fax Number	:	310-278-7595

Provider Business Practice Location Address
First Line	:	8631 W 3RD ST STE 1115
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5914
Country	:	US
Telephone Number	:	310-278-8330
Fax Number	:	310-278-7595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	07/01/2026

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