Organization
BRENTWOOD MEDICAL GROUP A PROFESSIONAL MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAVID TAVARI D.O. (PRESIDENT)
(310) 696-0101
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BLVD, SUITE 745, LOS ANGELES, CA 90025-1708
(310) 696-0101
Mailing address
11645 WILSHIRE BLVD, SUITE 745, LOS ANGELES, CA 90025-1708
(310) 696-0101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A6273
CA
Other
Enumeration date
11/19/2012
Last updated
02/26/2018
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