| Ronak Kavian Md Inc | |
|
5901 W Olympic Blvd Ste 504 Los Angeles CA 90036-4633 | |
| (310) 801-4706 | |
| Not Available |
| Full Name | Ronak Kavian Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5901 W Olympic Blvd Ste 504, Los Angeles, California |
| Authorized Official Name and Position | Ronak Kavian (EMPLOYEE) |
| Authorized Official Contact | 3108014706 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronak Kavian Md Inc 640 Hermosa Ave Hermosa Beach CA 90254-4441 Ph: (310) 801-4706 | Ronak Kavian Md Inc 5901 W Olympic Blvd Ste 504 Los Angeles CA 90036-4633 Ph: (310) 801-4706 |
| NPI Number | 1013521137 |
|---|---|
| Provider Enumeration Date | 09/04/2020 |
| Last Update Date | 09/04/2020 |
| Medicare PECOS PAC ID | 6406275262 |
|---|---|
| Medicare Enrollment ID | O20200928001541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013521137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronak Kavian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124467519 PECOS PAC ID: 4385925791 Enrollment ID: I20161223000071 |
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