Provider Demographics
NPI:1447647615
Name:TAGHAVI, ARASH (MD)
Entity type:Individual
Prefix:MR
First Name:ARASH
Middle Name:
Last Name:TAGHAVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10658
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-3658
Mailing Address - Country:US
Mailing Address - Phone:310-858-6500
Mailing Address - Fax:
Practice Address - Street 1:2080 CENTURY PARK E STE 1405
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2017
Practice Address - Country:US
Practice Address - Phone:310-858-6500
Practice Address - Fax:310-606-2648
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA149825207R00000X, 207RC0000X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program