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NPI Code Detail

MEDICARE: MMI MEDICAL GROUP, INC.

MEDICARE: MMI MEDICAL GROUP, INC.
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
1332900000XNon-Pharmacy Dispensing SiteG78454CA
2261QI0500XInfusion Therapy Clinic/Center

General Provider Information

NPI Number : 1396159778
Entity Type Code : Organization
Provider Name (Legal Business Name) : MMI MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : 8447 WILSHIRE BLVD STE 202
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-3207
Country : US
Telephone Number :
Fax Number : 310-861-8159
Provider Business Practice Location Address
First Line : 2080 CENTURY PARK E STE 710
Second Line :
City : LOS ANGELES
State : CA
Zip : 90067-2010
Country : US
Telephone Number : 310-715-3237
Fax Number : 310-861-8159
Authorized Official
Title or Position : VP, OPERATIONS
Name : MARIETTE N AROUTIOUNIAN
Credential :
Telephone Number : 323-236-4709
Provider Enumeration Date : 06/13/2014
Last Update Date : 07/20/2023

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