# PERSEPOLIS GROUP LLC

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

## Provider details

- **NPI number:** 1801185665
- **Authorized official:** MS. PANTEA ILBEIGI JD (ADMINISTRATIVE MANAGER)
- **Authorized official phone:** (973) 303-2848

## Contact information

- **Practice address:** 18400 US HIGHWAY 18, SUITE B, APPLE VALLEY, CA 92307-2306
- **Practice address phone:** (760) 810-7590
- **Practice address fax:** (760) 810-7593
- **Mailing address:** 12277 APPLE VALLEY RD, PMB\#397, APPLE VALLEY, CA 92308-1701
- **Mailing address phone:** (760) 242-3939
- **Mailing address fax:** (760) 810-7593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | CA | Yes |

## Other

- **Enumeration date:** 04/01/2011
- **Last updated:** 04/24/2024