Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brentwood Medical Group a Professional Medical Corp

Organization Internal Medicine Physician · NPI 1720322415

Brentwood Medical Group a Professional Medical Corp is an Internal Medicine Physician in Los Angeles, California. Licensed in California. Registered with an NPI since 2012.

Licensed in
CA
In the registry since
2012
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11645 Wilshire Blvd Ste 745
Los Angeles, CA 90025-1708
Phone: (310) 696-0101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 20A6273 (CA)

Record details

NPI number1720322415
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Javid Tavari — President · (310) 696-0101
NPI enumeratedNovember 19, 2012
Last updated in NPPESFebruary 26, 2018
Mailing address11645 Wilshire Blvd, Suite 745, Los Angeles, CA 90025-1708

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