Provider Demographics
NPI:1245544931
Name:WILSHIRE CRESCENT HEIGHTS MEDICAL CENTER A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:WILSHIRE CRESCENT HEIGHTS MEDICAL CENTER A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MALIHE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARDASHTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-360-9785
Mailing Address - Street 1:8500 WILSHIRE BLVD STE 625
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3120
Mailing Address - Country:US
Mailing Address - Phone:310-360-9785
Mailing Address - Fax:310-360-9889
Practice Address - Street 1:8500 WILSHIRE BLVD STE 625
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3120
Practice Address - Country:US
Practice Address - Phone:310-360-9785
Practice Address - Fax:310-360-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA401920261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care