Organization
PEYMAN BANOONI MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PEYMAN BANOONI M.D. (MEDICAL DIRECTOR)
(310) 625-4643
Entity
Organization
Contact information
Practice address
1030 GARDENA BLVD, GARDENA, CA 90247-4956
(213) 413-2222
Mailing address
269 S BEVERLY DR, SUITE 468, BEVERLY HILLS, CA 90212-3851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
A75080
CA
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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