MEDICARE: DR. KAMI ADIBI 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	207QA0401X	Addiction Medicine (Family Medicine) Physician	A64723	CA
2	207Q00000X	Family Medicine Physician	A64723	CA

General Provider Information

NPI Number	:	1548211436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMI ADIBI M.D.

Provider Business Mailing Address
First Line	:	1414 S GRAND AVE STE 380
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3072
Country	:	US
Telephone Number	:	310-717-5777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1414 S GRAND AVE STE 380
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3072
Country	:	US
Telephone Number	:	310-717-5777
Fax Number	:	818-578-8865

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/26/2024

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Directions to “ DR. KAMI ADIBI M.D.” Practice Location

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