Provider Demographics
NPI:1275970865
Name:VALA, KIANA (DO)
Entity Type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:VALA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KIANA
Other - Middle Name:
Other - Last Name:KOUCHAKZADEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5611 HOWE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2415
Mailing Address - Country:US
Mailing Address - Phone:813-205-7637
Mailing Address - Fax:
Practice Address - Street 1:5215 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1303
Practice Address - Country:US
Practice Address - Phone:412-623-2817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT015211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOT015211OtherTRAINING LICENCE NUMBER