Provider Demographics
NPI:1437100278
Name:FAHIMIAN, NIMA A (MD)
Entity Type:Individual
Prefix:
First Name:NIMA
Middle Name:A
Last Name:FAHIMIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SANTA MONICA BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2639
Mailing Address - Country:US
Mailing Address - Phone:424-257-8292
Mailing Address - Fax:424-238-3030
Practice Address - Street 1:435 N BEDFORD DR
Practice Address - Street 2:STE 313
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4358
Practice Address - Country:US
Practice Address - Phone:424-257-8292
Practice Address - Fax:424-238-3030
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85986174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist