Organization
MIRACLE MILE MULTISPECIALTY GROUP
Active
Other names
Miracle Mile Multispecialty Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHBAZ FARNAD MD (MEDICAL DIRECTOR)
(310) 383-1400
Entity
Organization
Contact information
Practice address
5757 WILSHIRE BLVD STE PR6, LOS ANGELES, CA 90036-3689
(323) 433-7744
Mailing address
5757 WILSHIRE BLVD STE PR6, LOS ANGELES, CA 90036-3689
(323) 433-7744
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
03/22/2023
Last updated
04/25/2023
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