Provider Demographics
NPI:1497996292
Name:KIAN KAVEH D.O INC
Entity Type:Organization
Organization Name:KIAN KAVEH D.O INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVEH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-804-0211
Mailing Address - Street 1:5875 S RAINBOW BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2554
Mailing Address - Country:US
Mailing Address - Phone:702-804-0211
Mailing Address - Fax:702-853-4215
Practice Address - Street 1:5875 S RAINBOW BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2554
Practice Address - Country:US
Practice Address - Phone:702-804-0211
Practice Address - Fax:702-853-4215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV718207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty