Provider Demographics
NPI:1659711695
Name:KOUCHESFEHANI, ARASH
Entity Type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:KOUCHESFEHANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 NOYO DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3721
Mailing Address - Country:US
Mailing Address - Phone:408-375-7385
Mailing Address - Fax:
Practice Address - Street 1:178 NOYO DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3721
Practice Address - Country:US
Practice Address - Phone:408-375-7385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies