# T NIKRAVESH MD CORPORATION

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

## Provider details

- **NPI number:** 1730190901
- **Authorized official:** DR. TANNAZ NIKRAVESH MD (PRESIDENT)
- **Authorized official phone:** (310) 659-2226

## Contact information

- **Practice address:** 6404 WILSHIRE BLVD STE 600, LOS ANGELES, CA 90048-5508
- **Practice address phone:** (310) 659-2226
- **Practice address fax:** (323) 782-8528
- **Mailing address:** 6404 WILSHIRE BLVD STE 600, LOS ANGELES, CA 90048-5508
- **Mailing address phone:** (310) 659-2226
- **Mailing address fax:** (323) 782-8528

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 04/30/2008