Provider Demographics
NPI:1821310939
Name:HOSEIN T. AFSHAR, M.D., A MEDICAL CORP.
Entity Type:Organization
Organization Name:HOSEIN T. AFSHAR, M.D., A MEDICAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSEIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:AFSHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:805-373-5144
Mailing Address - Street 1:2230 LYNN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1901
Mailing Address - Country:US
Mailing Address - Phone:805-373-5144
Mailing Address - Fax:805-373-5123
Practice Address - Street 1:2230 LYNN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1901
Practice Address - Country:US
Practice Address - Phone:805-373-5144
Practice Address - Fax:805-373-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC35453Medicare UPIN