Organization
SHAHBAZ FARNAD MD PROFESSIONAL CORPORATION
Active
Other names
Miracle Mile Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHBAZ FARNAD MD (OWNER)
(310) 383-1400
Entity
Organization
Contact information
Practice address
5757 WILSHIRE BLVD, PROMENADE 2, LOS ANGELES, CA 90036
(310) 383-1400
Mailing address
5757 WILSHIRE BLVD, PROMENADE 2, LOS ANGELES, CA 90036
(310) 383-1400
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
09/25/2018
Last updated
05/10/2024
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