| NPI | 1871078972 |
|---|---|
| Doing Business As | MIRACLE MILE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | SHAHBAZ FARNAD Owner 310-383-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 207Y00000X Otolaryngology | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2024-05-10 |