Organization
INTEGRATED HEALTHCARE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMRAN BROUKHIM M.D. (PRESIDENT/MEDICAL DIRECTOR)
(310) 441-2000
Entity
Organization
Contact information
Practice address
1762 WESTWOOD BLVD, SUITE 300, LOS ANGELES, CA 90024-5632
(310) 441-2000
(310) 441-2020
Mailing address
1762 WESTWOOD BLVD, SUITE 300, LOS ANGELES, CA 90024-5632
(310) 441-2000
(310) 441-2020
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
A38857
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0085621
—
CA
01
—
RCF00030F
RCFE PROVIDER
CA
Enumeration date
08/27/2007
Last updated
08/27/2007
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