Provider Demographics
NPI:1144480252
Name:KAMYAR AMINI MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:KAMYAR AMINI MD A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALOUMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:YARAGHCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-709-6604
Mailing Address - Street 1:14600 SHERMAN WAY STE 250
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2284
Mailing Address - Country:US
Mailing Address - Phone:818-998-6600
Mailing Address - Fax:818-495-4031
Practice Address - Street 1:14600 SHERMAN WAY STE 250
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2284
Practice Address - Country:US
Practice Address - Phone:818-998-6600
Practice Address - Fax:818-495-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99444261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty