MEDICARE: RAMIN NEMATOLLAHI

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	106H00000X	Marriage & Family Therapist	102792	CA

General Provider Information

NPI Number	:	1538672027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMIN NEMATOLLAHI

Provider Business Mailing Address
First Line	:	6695 GREEN VALLEY CIR UNIT 2492
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90231-5624
Country	:	US
Telephone Number	:	562-726-4618
Fax Number	:

Provider Business Practice Location Address
First Line	:	6695 GREEN VALLEY CIR UNIT 2492
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90231-5624
Country	:	US
Telephone Number	:	562-726-4618
Fax Number	:

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

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	04/23/2024

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Directions to “ RAMIN NEMATOLLAHI ” Practice Location

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