Provider Demographics
NPI:1548416555
Name:KAMRAVA, ALLEN (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:KAMRAVA
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 N BEDFORD DR STE 308
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4380
Mailing Address - Country:US
Mailing Address - Phone:424-279-8222
Mailing Address - Fax:424-279-8226
Practice Address - Street 1:435 N BEDFORD DR STE 308
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4380
Practice Address - Country:US
Practice Address - Phone:424-279-8222
Practice Address - Fax:424-279-8226
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-09
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103694208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery