Provider Demographics
NPI:1235376377
Name:KHORSANDI, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:KHORSANDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4616 W SAHARA AVE
Mailing Address - Street 2:SUITE 376
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-3654
Mailing Address - Country:US
Mailing Address - Phone:702-608-1318
Mailing Address - Fax:
Practice Address - Street 1:2779 SUNRIDGE HEIGHTS PKWY
Practice Address - Street 2:STE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5050
Practice Address - Country:US
Practice Address - Phone:702-608-1318
Practice Address - Fax:702-446-8026
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1043462082S0105X
NV130442086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand