Provider Demographics
NPI:1538488614
Name:KAVEH S KASHANI DO INC
Entity Type:Organization
Organization Name:KAVEH S KASHANI DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:S
Authorized Official - Last Name:KASHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-599-9567
Mailing Address - Street 1:P.O. BOX 6187
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806
Mailing Address - Country:US
Mailing Address - Phone:562-788-3362
Mailing Address - Fax:562-788-7090
Practice Address - Street 1:2575 S. CIMARRON DR.
Practice Address - Street 2:SUITE 104
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2682
Practice Address - Country:US
Practice Address - Phone:562-788-3362
Practice Address - Fax:562-788-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10720207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty