Provider Demographics
NPI:1679378293
Name:ELEVATE MIND AND WELLNESS, INC.
Entity type:Organization
Organization Name:ELEVATE MIND AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASTGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-425-3558
Mailing Address - Street 1:9100 WILSHIRE BLVD
Mailing Address - Street 2:EAST TOWER SUITE 333 #1036
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212
Mailing Address - Country:US
Mailing Address - Phone:310-425-4558
Mailing Address - Fax:651-666-1450
Practice Address - Street 1:9100 WILSHIRE BLVD
Practice Address - Street 2:EAST TOWER SUITE 333 #1036
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-425-4558
Practice Address - Fax:651-666-1450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty