Organization
CALIFORNIA SPORTS & REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHOLEH HAKIMIAN (OFFICE ADMINISTRATOR)
(310) 652-6060
Entity
Organization
Contact information
Practice address
16661 VENTURA BLVD, SUITE 714, ENCINO, CA 91436
(818) 784-6961
(818) 784-2336
Mailing address
50 N LA CIENEGA BLVD, SUITE 219, BEVERLY HILLS, CA 90211
(310) 652-6060
(310) 652-6607
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A38773
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A387732
MEDI-CAL
CA
Enumeration date
09/01/2006
Last updated
02/01/2021
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