Provider Demographics
NPI:1588823181
Name:JARRAHNEJAD, PAYAM (MD)
Entity Type:Individual
Prefix:DR
First Name:PAYAM
Middle Name:
Last Name:JARRAHNEJAD
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 1:465 N ROXBURY DRIVE
Mailing Address - Street 2:SUITE 1017
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:310-993-3800
Mailing Address - Fax:310-388-1617
Practice Address - Street 1:465 N ROXBURY DR STE 1017
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4213
Practice Address - Country:US
Practice Address - Phone:310-993-3800
Practice Address - Fax:310-388-1617
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89098208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery