Provider Demographics
NPI:1558591933
Name:KASHEFI, AMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:KASHEFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AMIR
Other - Middle Name:
Other - Last Name:KASHEFI TAGHIPOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23141 VERDUGO DRIVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-215-5055
Mailing Address - Fax:949-326-5099
Practice Address - Street 1:18350 ROSCOE BLVD # 307
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325
Practice Address - Country:US
Practice Address - Phone:949-215-5055
Practice Address - Fax:949-326-5099
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1168892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology