Provider Demographics
NPI:1164820114
Name:PARTOVI, PANTEHA (PA)
Entity type:Individual
Prefix:
First Name:PANTEHA
Middle Name:
Last Name:PARTOVI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 WILSHIRE BLVD STE 615
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3146
Mailing Address - Country:US
Mailing Address - Phone:310-740-9373
Mailing Address - Fax:
Practice Address - Street 1:8500 WILSHIRE BLVD STE 615
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3146
Practice Address - Country:US
Practice Address - Phone:310-740-9373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52118363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant