Provider Demographics
NPI:1538335567
Name:FORAT, BEHNAZ (LAC)
Entity type:Individual
Prefix:MRS
First Name:BEHNAZ
Middle Name:
Last Name:FORAT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8909 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3551
Mailing Address - Country:US
Mailing Address - Phone:310-289-5924
Mailing Address - Fax:
Practice Address - Street 1:8909 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3551
Practice Address - Country:US
Practice Address - Phone:310-289-5924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 4962171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist