# BAHAREH FAZILAT MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043746316
- **Authorized official:** BAHAREH FAZILAT MD (MD)
- **Authorized official phone:** (786) 525-8898

## Contact information

- **Practice address:** 4940 VAN NUYS BLVD STE 302, SHERMAN OAKS, CA 91403-1743
- **Practice address phone:** (310) 507-7748
- **Practice address fax:** (310) 598-7997
- **Mailing address:** 4940 VAN NUYS BLVD STE 302, SHERMAN OAKS, CA 91403-1743
- **Mailing address phone:** (310) 507-7748
- **Mailing address fax:** (310) 598-7997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/05/2017
- **Last updated:** 10/22/2024