Provider Demographics
NPI:1699960633
Name:MALEK, MASOUD (MD)
Entity type:Individual
Prefix:DR
First Name:MASOUD
Middle Name:
Last Name:MALEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S LA CIENEGA
Mailing Address - Street 2:# 204
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3302
Mailing Address - Country:US
Mailing Address - Phone:310-358-9300
Mailing Address - Fax:323-282-5470
Practice Address - Street 1:250 S LA CIENEGA BLVD
Practice Address - Street 2:# 204
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3302
Practice Address - Country:US
Practice Address - Phone:310-358-9300
Practice Address - Fax:310-358-9156
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA038198174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist