Provider Demographics
NPI:1740998467
Name:HAKIMI, MOHAMMAD ALI (LAC, DIPL OM, DAOM)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:ALI
Last Name:HAKIMI
Suffix:
Gender:M
Credentials:LAC, DIPL OM, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18653 VENTURA BLVD # 825
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4103
Mailing Address - Country:US
Mailing Address - Phone:310-985-7828
Mailing Address - Fax:
Practice Address - Street 1:2001 S BARRINGTON AVE STE 111
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5337
Practice Address - Country:US
Practice Address - Phone:310-985-7828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17901171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist