Provider Demographics
NPI:1144391046
Name:FEIZBAKHSH, FRAZIN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRAZIN
Middle Name:
Last Name:FEIZBAKHSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:FEIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9663 SANTA MONICA BLVD
Mailing Address - Street 2:#294
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4303
Mailing Address - Country:US
Mailing Address - Phone:310-855-8058
Mailing Address - Fax:310-855-8059
Practice Address - Street 1:450 N ROXBURY DR STE 602
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4220
Practice Address - Country:US
Practice Address - Phone:310-855-8058
Practice Address - Fax:310-929-9765
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAI37849208600000X
CAA79543174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI37849Medicare UPIN