MEDICARE: ELHAM RAMTIN

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1538824339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELHAM RAMTIN

Provider Business Mailing Address
First Line	:	PO BOX 5373
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90209-5373
Country	:	US
Telephone Number	:	949-354-3550
Fax Number	:	949-281-1199

Provider Business Practice Location Address
First Line	:	12843 LANDALE ST
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-1352
Country	:	US
Telephone Number	:	949-354-3550
Fax Number	:	949-281-1199

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ELHAM RAMTIN
Credential	:	PSYD
Telephone Number	:	949-354-3550

Provider Enumeration Date	:	11/05/2021
Last Update Date	:	12/02/2021

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