Provider Demographics
NPI:1801484241
Name:MASOUD AFSHAR MD INC
Entity type:Organization
Organization Name:MASOUD AFSHAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MASOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:AFSHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:442-283-5049
Mailing Address - Street 1:220 N IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-1265
Mailing Address - Country:US
Mailing Address - Phone:442-283-5049
Mailing Address - Fax:760-344-7106
Practice Address - Street 1:220 N IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-1265
Practice Address - Country:US
Practice Address - Phone:442-283-5049
Practice Address - Fax:760-344-7106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-31
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty