Provider Demographics
NPI:1982158663
Name:BEVERLY HILLS MIGRAINE AND PAIN MANAGEMENT INSTITUTE, INC
Entity Type:Organization
Organization Name:BEVERLY HILLS MIGRAINE AND PAIN MANAGEMENT INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAIMOORAZY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-302-0289
Mailing Address - Street 1:436 N ROXBURY DR STE 115
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5016
Mailing Address - Country:US
Mailing Address - Phone:424-302-0289
Mailing Address - Fax:
Practice Address - Street 1:436 N ROXBURY DR STE 115
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5016
Practice Address - Country:US
Practice Address - Phone:424-302-0289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty