| 7th Street Medical Group | |
|
1919 W 7th St Unit 2a Los Angeles CA 90057-4103 | |
| (310) 625-4643 | |
| (310) 652-3489 |
| Full Name | 7th Street Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1919 W 7th St, Los Angeles, California |
| Authorized Official Name and Position | Peyman Banooni (OWNER) |
| Authorized Official Contact | 3106254643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 7th Street Medical Group 1919 W 7th St Unit 2a Los Angeles CA 90057-4103 Ph: (310) 625-4643 | 7th Street Medical Group 1919 W 7th St Unit 2a Los Angeles CA 90057-4103 Ph: (310) 625-4643 |
| NPI Number | 1689978850 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 01/03/2011 |
| Medicare PECOS PAC ID | 6507031226 |
|---|---|
| Medicare Enrollment ID | O20111208000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689978850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| Provider Name | Jose M Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427078781 PECOS PAC ID: 9032009329 Enrollment ID: I20040318001739 |
| Provider Name | Arash Bereliani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699722165 PECOS PAC ID: 6002808714 Enrollment ID: I20040401001204 |
| Provider Name | Peyman Banooni |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811002777 PECOS PAC ID: 6406830322 Enrollment ID: I20040617000536 |
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