Provider Demographics
NPI:1013521137
Name:RONAK KAVIAN MD INC
Entity Type:Organization
Organization Name:RONAK KAVIAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:310-801-4706
Mailing Address - Street 1:640 HERMOSA AVE
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-4441
Mailing Address - Country:US
Mailing Address - Phone:310-801-4706
Mailing Address - Fax:
Practice Address - Street 1:5901 W OLYMPIC BLVD STE 504
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4633
Practice Address - Country:US
Practice Address - Phone:310-801-4706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty