Miracle Mile Multispecialty Group

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MIRACLE MILE MULTISPECIALTY GROUP

Practice address

5757 Wilshire Blvd Ste PR6
Los Angeles, CA 90036-3689

Phone

(323) 433-7744

NPI assigned

Mar 22, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shahbaz Farnad, MD

Title

Medical Director

Phone

(310) 383-1400

Specialties & licenses 1

Addresses

Other names 1

• Miracle Mile Multispecialty Group Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1154023067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD STE PR6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363689",
            "telephone_number": "323-433-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD STE PR6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363689",
            "telephone_number": "323-433-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE MILE MULTISPECIALTY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "FARNAD",
        "authorized_official_first_name": "SHAHBAZ",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-383-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miracle Mile Multispecialty Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Miracle Mile Multispecialty Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.