Provider Demographics
NPI:1336835081
Name:BABAK BINA D O INC
Entity Type:Organization
Organization Name:BABAK BINA D O INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:BINA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-463-7104
Mailing Address - Street 1:2700 NEILSON WAY APT 327
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4013
Mailing Address - Country:US
Mailing Address - Phone:310-463-7104
Mailing Address - Fax:
Practice Address - Street 1:150 VIA MERIDA
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3816
Practice Address - Country:US
Practice Address - Phone:805-497-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty