Provider Demographics
NPI:1730856592
Name:BABAK BOBBY ROSTAMI MD APC
Entity type:Organization
Organization Name:BABAK BOBBY ROSTAMI MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSTAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD INTERNAL MEDICI
Authorized Official - Phone:310-963-4786
Mailing Address - Street 1:113 N SAN VICENTE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2329
Mailing Address - Country:US
Mailing Address - Phone:213-999-1850
Mailing Address - Fax:
Practice Address - Street 1:9616 CRESTA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4004
Practice Address - Country:US
Practice Address - Phone:213-999-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty