Provider Demographics
NPI:1609108760
Name:BABAK ABEDI M.D., INC.
Entity Type:Organization
Organization Name:BABAK ABEDI M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-880-2536
Mailing Address - Street 1:7095 HOLLYWOOD BLVD
Mailing Address - Street 2:706
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-8903
Mailing Address - Country:US
Mailing Address - Phone:323-745-7700
Mailing Address - Fax:
Practice Address - Street 1:7095 HOLLYWOOD BLVD
Practice Address - Street 2:706
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-8903
Practice Address - Country:US
Practice Address - Phone:323-745-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95902207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty