Provider Demographics
NPI:1922058593
Name:PARSAPOUR, KOUROSH (MD)
Entity Type:Individual
Prefix:MR
First Name:KOUROSH
Middle Name:
Last Name:PARSAPOUR
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:17100 EUCLID ST
Mailing Address - Street 2:DEPARTMENT PICU PEDS
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708
Mailing Address - Country:US
Mailing Address - Phone:714-966-7253
Mailing Address - Fax:714-966-3354
Practice Address - Street 1:17100 EUCLID ST
Practice Address - Street 2:DEPARTMENT PICU PEDS
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708
Practice Address - Country:US
Practice Address - Phone:714-966-7253
Practice Address - Fax:714-966-3354
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA798562080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI25813Medicare UPIN