Organization
DR BAHAREH FAZILAT MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAHAREH FAZILAT MD (PRESIDENT)
(310) 507-7748
Entity
Organization
Contact information
Practice address
4940 VAN NUYS BLVD STE 302, SHERMAN OAKS, CA 91403-1743
(310) 507-7748
(310) 598-7997
Mailing address
4940 VAN NUYS BLVD STE 302, SHERMAN OAKS, CA 91403-1743
(310) 507-7748
(310) 598-7997
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
Other
Enumeration date
12/09/2025
Last updated
12/09/2025
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