Provider Demographics
NPI:1841785557
Name:DOCTOR KASH LLC
Entity Type:Organization
Organization Name:DOCTOR KASH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:S
Authorized Official - Last Name:KASHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-599-9567
Mailing Address - Street 1:4525 DEAN MARTIN DR UNIT 511
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-8107
Mailing Address - Country:US
Mailing Address - Phone:562-599-9567
Mailing Address - Fax:
Practice Address - Street 1:8225 W SAHARA AVE STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8929
Practice Address - Country:US
Practice Address - Phone:562-599-9567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO2074207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty