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Organization

LA SPINE INTERVENTION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EVISH KAMRAVA MD (PRESIDENT)
(310) 828-7757
Entity
Organization

Contact information

Practice address
2811 WILSHIRE BLVD, SUITE 850, SANTA MONICA, CA 90403-4803
(310) 828-7757
(310) 594-8924
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
(855) 898-4055

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Enumeration date
10/24/2014
Last updated
10/17/2022
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