Provider Demographics
NPI:1205903762
Name:HASHEMIYOON, ROBERT BABAK (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BABAK
Last Name:HASHEMIYOON
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 1:17525 VENTURA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-5109
Mailing Address - Country:US
Mailing Address - Phone:310-271-5875
Mailing Address - Fax:818-387-6804
Practice Address - Street 1:17525 VENTURA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5109
Practice Address - Country:US
Practice Address - Phone:310-271-5875
Practice Address - Fax:818-387-6804
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G86202Medicare PIN