Provider Demographics
NPI:1184953119
Name:YOUNESSIAN PEDOUIM, SHOHREH (ACUPUNCTURIST)
Entity type:Individual
Prefix:DR
First Name:SHOHREH
Middle Name:
Last Name:YOUNESSIAN PEDOUIM
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:145 N ALMONT DR
Mailing Address - Street 2:#2
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1819
Mailing Address - Country:US
Mailing Address - Phone:310-205-9114
Mailing Address - Fax:310-859-4745
Practice Address - Street 1:4201 WILSHIRE BLVD
Practice Address - Street 2:STE. 515
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3601
Practice Address - Country:US
Practice Address - Phone:310-205-9114
Practice Address - Fax:310-859-4745
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA9391171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist