Provider Demographics
NPI:1659344786
Name:KASHANI, JAVAD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVAD
Middle Name:
Last Name:KASHANI
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 1:23240 CHAGRIN BLVD
Mailing Address - Street 2:COMMERCE PARK IV SUITE 610
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-595-0500
Mailing Address - Fax:216-595-0547
Practice Address - Street 1:23240 CHAGRIN BLVD
Practice Address - Street 2:COMMERCE PARK IV SUITE 610
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-595-0500
Practice Address - Fax:216-595-0547
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350619122084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI20213391Medicaid
E68861Medicare UPIN
MI20213391Medicaid