Provider Demographics
NPI:1144222571
Name:KIAN, HOMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOMAN
Middle Name:
Last Name:KIAN
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:P.O. BOX 7001 DEPARTMENT OF STATE HOSPITALS-ATASCADERO
Mailing Address - Street 2:10333 EL CAMINO REAL
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93423-7001
Mailing Address - Country:US
Mailing Address - Phone:805-468-3198
Mailing Address - Fax:
Practice Address - Street 1:10333 EL CAMINO REAL
Practice Address - Street 2:DEPARTMENT OF STATE HOSPITALS - ATASCADERO
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93423-7001
Practice Address - Country:US
Practice Address - Phone:916-651-9475
Practice Address - Fax:916-651-8908
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine