Provider Demographics
NPI:1164873840
Name:KHOSROVI-EGHBAL, ARASH (MD)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:KHOSROVI-EGHBAL
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 1:2400 WIBLE RD STE 14
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-4734
Mailing Address - Country:US
Mailing Address - Phone:661-835-1240
Mailing Address - Fax:661-835-4667
Practice Address - Street 1:2400 WIBLE RD STE 14
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-4734
Practice Address - Country:US
Practice Address - Phone:661-835-1240
Practice Address - Fax:661-835-4667
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61434850207R00000X
CAA157669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine