Individual
BRYAN DANIEL KIMIABAKHSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
2021 SANTA MONICA BLVD STE 625E, SANTA MONICA, CA 90404-2169
(310) 829-8948
(424) 212-5937
Mailing address
38 HEMLOCK DRIVE, GREAT NECK, NY 11024
(516) 984-9199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A196784
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2019
Last updated
01/02/2025
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