Provider Demographics
NPI:1396708772
Name:KALHOR, NASIM (DPM)
Entity type:Individual
Prefix:
First Name:NASIM
Middle Name:
Last Name:KALHOR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SOLAR DR.
Mailing Address - Street 2:SUITE # 102
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036
Mailing Address - Country:US
Mailing Address - Phone:805-988-3338
Mailing Address - Fax:805-830-1537
Practice Address - Street 1:2100 SOLAR DR.
Practice Address - Street 2:SUITE # 102
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036
Practice Address - Country:US
Practice Address - Phone:805-988-3338
Practice Address - Fax:805-830-1537
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4581213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW11945AOtherMEDICARE ID - LANCASTER
CAWE4581BOtherMEDICARE ID- LANCASTER
CADA0572OtherRAILROAD CARRIER
CAW11945OtherMEDICARE ID - SHERMAN OAKS
CAWE4581AOtherMEDICARE ID - SHERMAN OAKS
CAWE4581BOtherMEDICARE ID- LANCASTER
CA0368280002Medicare NSC
CA0368280001Medicare NSC
CAW11945AOtherMEDICARE ID - LANCASTER