| Javid Tavari, D.o., Inc. | |
|
11645 Wilshire Blvd Suite 745 Los Angeles CA 90025-1708 | |
| (310) 696-0100 | |
| (310) 696-0700 |
| Full Name | Javid Tavari, D.o., Inc. |
|---|---|
| Speciality | Internal Medicine - Sports Medicine |
| Location | 11645 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Javid D Tavari (CEO) |
| Authorized Official Contact | 3106960100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Javid Tavari, D.o., Inc. 11645 Wilshire Blvd Suite 745 Los Angeles CA 90025-1708 Ph: (310) 696-0100 | Javid Tavari, D.o., Inc. 11645 Wilshire Blvd Suite 745 Los Angeles CA 90025-1708 Ph: (310) 696-0100 |
| NPI Number | 1992840680 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 10/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992840680 | NPI | - | NPPES |
| 020A62731 | Other | CA | BLUE SHIELD |
| 020A62731 | Other | CA | BLUE CROSS |
| 020A62730 | Other | CA | BLUE CROSS |
| FNP2021 | Other | CA | OSTEOPATHIC MEDICAL BOARD OF CALIFORNIA |
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