Provider Demographics
NPI:1508983057
Name:BAHIN-AEIN, ASHKAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHKAN
Middle Name:
Last Name:BAHIN-AEIN
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:PO BOX 740433
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-0433
Mailing Address - Country:US
Mailing Address - Phone:775-352-5301
Mailing Address - Fax:775-352-5303
Practice Address - Street 1:2375 E PRATER WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-9641
Practice Address - Country:US
Practice Address - Phone:775-352-5301
Practice Address - Fax:775-352-5303
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13169208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1508983057OtherNPI
12162269OtherCAQH
NVCM893XMedicare PIN