Provider Demographics
NPI:1447740493
Name:VARICOSE RELIEF INC
Entity Type:Organization
Organization Name:VARICOSE RELIEF INC
Other - Org Name:KTOWN MEDSPA & VARICOSE RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D./CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-367-3268
Mailing Address - Street 1:3130 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2484
Mailing Address - Country:US
Mailing Address - Phone:323-733-1004
Mailing Address - Fax:323-733-1003
Practice Address - Street 1:3130 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2484
Practice Address - Country:US
Practice Address - Phone:323-733-1004
Practice Address - Fax:323-733-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86162207RC0200X, 207RP1001X, 261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty