Provider Demographics
NPI:1326246018
Name:KHITRI, AVINASH RAMESH (MD)
Entity Type:Individual
Prefix:DR
First Name:AVINASH
Middle Name:RAMESH
Last Name:KHITRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3452 E FOOTHILL BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-6006
Mailing Address - Country:US
Mailing Address - Phone:626-793-2885
Mailing Address - Fax:626-793-6262
Practice Address - Street 1:315 N THIRD AVE
Practice Address - Street 2:STE 207
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1917
Practice Address - Country:US
Practice Address - Phone:626-915-4700
Practice Address - Fax:626-214-7814
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2016-09-19
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Provider Licenses
StateLicense IDTaxonomies
CAA128322207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB260922Medicare PIN
CACB218745Medicare PIN