Organization
SPECIALIZED PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIARASH MICHEL M.D. (OWNER / PHYSICIAN)
(310) 278-8330
Entity
Organization
Contact information
Practice address
8631 W 3RD ST STE 715E, LOS ANGELES, CA 90048-5911
(310) 278-8330
(310) 278-7595
Mailing address
8631 W 3RD ST STE 715E, LOS ANGELES, CA 90048-5911
(310) 278-8330
(310) 278-7595
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G81612
CA
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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