Provider Demographics
NPI:1407949274
Name:HELWANI, BERJOUHI
Entity type:Individual
Prefix:
First Name:BERJOUHI
Middle Name:
Last Name:HELWANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 TORRANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3326
Mailing Address - Country:US
Mailing Address - Phone:310-937-3650
Mailing Address - Fax:310-937-3652
Practice Address - Street 1:401 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3326
Practice Address - Country:US
Practice Address - Phone:310-937-3650
Practice Address - Fax:310-937-3652
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA330748669332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02143GMedicaid
CADME02143GMedicaid