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Organization
AVICCENNA MEDICAL GROUP
Active
Organization
AVICCENNA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEYED FARHAD N CHIMEH MD (PRESIDENT)
(310) 858-1800
Entity
Organization
Contact information
Practice address
435 N BEDFORD DR, SUITE # 312, BEVERLY HILLS, CA 90210-4321
(310) 858-1800
Mailing address
3392 MOTOR AVE, LOS ANGELES, CA 90034-3712
(310) 858-1800
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A100198
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2074290
—
CA
Enumeration date
01/05/2009
Last updated
07/01/2009
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