MEDICARE: TANIA KIMIA MD

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	207K00000X	Allergy & Immunology Physician	A70419	CA
2	2080P0201X	Pediatric Allergy/Immunology Physician	A70419	CA

General Provider Information

NPI Number	:	1295934826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA KIMIA MD

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1260 15TH ST STE 1002
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1145
Country	:	US
Telephone Number	:	424-259-8570
Fax Number	:

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	11/22/2024

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Directions to “ TANIA KIMIA MD” Practice Location

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