Provider Demographics
NPI:1770947384
Name:KELESHIAN, VASKEN LEON (MD)
Entity type:Individual
Prefix:DR
First Name:VASKEN
Middle Name:LEON
Last Name:KELESHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 CITRACADO PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-4151
Mailing Address - Country:US
Mailing Address - Phone:760-743-0546
Mailing Address - Fax:760-743-8005
Practice Address - Street 1:2130 CITRACADO PKWY STE 220
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4151
Practice Address - Country:US
Practice Address - Phone:714-343-1039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-09
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA160638207R00000X, 207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA160638OtherMEDICAL LICENSE