Provider Demographics
NPI:1619389665
Name:SOORIASH, ROBBIE KAVEH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBBIE
Middle Name:KAVEH
Last Name:SOORIASH
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 1:25856 BELLIS DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2054
Mailing Address - Country:US
Mailing Address - Phone:310-625-0010
Mailing Address - Fax:
Practice Address - Street 1:25856 BELLIS DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2054
Practice Address - Country:US
Practice Address - Phone:310-625-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130322207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine