MEDICARE: DR. SOUSAN KARIMI 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	207RN0300X	Nephrology Physician	A68107	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A68107	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1497795140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOUSAN KARIMI M.D.,

Provider Business Mailing Address
First Line	:	8641 WILSHIRE BLVD STE 300
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2921
Country	:	US
Telephone Number	:	310-652-9162
Fax Number	:	310-854-7259

Provider Business Practice Location Address
First Line	:	8641 WILSHIRE BLVD STE 300
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2921
Country	:	US
Telephone Number	:	310-652-9162
Fax Number	:

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	04/20/2021

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