MEDICARE: DR. PAYAM JARRAHNEJAD MD

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	208200000X	Plastic Surgery Physician	A89098	CA

General Provider Information

NPI Number	:	1588823181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAYAM JARRAHNEJAD MD

Provider Business Mailing Address
First Line	:	465 N ROXBURY DRIVE
Second Line	:	SUITE 1017
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210
Country	:	US
Telephone Number	:	310-993-3800
Fax Number	:	310-388-1617

Provider Business Practice Location Address
First Line	:	465 N ROXBURY DR STE 1017
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4213
Country	:	US
Telephone Number	:	310-993-3800
Fax Number	:	310-388-1617

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

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	11/13/2018

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90210-4213

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Practice Fax: 310-388-1617

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