Provider Demographics
NPI:1841394913
Name:AFSHAR, HOSEIN T (MD FACC)
Entity Type:Individual
Prefix:DR
First Name:HOSEIN
Middle Name:T
Last Name:AFSHAR
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1687 ERRINGER RD
Mailing Address - Street 2:STE 207
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-584-8444
Mailing Address - Fax:805-584-3847
Practice Address - Street 1:1687 ERRINGER RD
Practice Address - Street 2:STE 207
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065
Practice Address - Country:US
Practice Address - Phone:805-584-8444
Practice Address - Fax:805-584-3847
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35988207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A359880Medicaid
CA00A359880Medicaid
CAA35988Medicare ID - Type Unspecified