Provider Demographics
NPI:1407289143
Name:NIMA M. GHARAVI, M.D., INC
Entity Type:Organization
Organization Name:NIMA M. GHARAVI, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GHARAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:310-892-7122
Mailing Address - Street 1:22287 MULHOLLAND HWY
Mailing Address - Street 2:SUITE 253
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5157
Mailing Address - Country:US
Mailing Address - Phone:310-892-7122
Mailing Address - Fax:
Practice Address - Street 1:22287 MULHOLLAND HWY
Practice Address - Street 2:SUITE 253
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5157
Practice Address - Country:US
Practice Address - Phone:310-892-7122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty