MEDICARE: HEALTH ACCESS FOR ALL 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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1447703400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH ACCESS FOR ALL INC

Provider Business Mailing Address
First Line	:	269 S BEVERLY DR
Second Line	:	SUITE468
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3851
Country	:	US
Telephone Number	:	310-625-4649
Fax Number	:	818-247-4905

Provider Business Practice Location Address
First Line	:	1919 W 7TH ST
Second Line	:	SUITE 2A
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4103
Country	:	US
Telephone Number	:	213-413-2222
Fax Number	:	213-483-1711

Authorized Official
Title or Position	:	CEO
Name	:	DR. PEYMAN BANOONI
Credential	:	M.D.
Telephone Number	:	310-625-4649

Provider Enumeration Date	:	07/26/2016
Last Update Date	:	04/19/2017

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