Provider Demographics
NPI:1912695842
Name:KHOSRAVI, RAMSESS (RVT)
Entity Type:Individual
Prefix:MR
First Name:RAMSESS
Middle Name:
Last Name:KHOSRAVI
Suffix:
Gender:M
Credentials:RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 VALLEY CIRCLE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2809
Mailing Address - Country:US
Mailing Address - Phone:747-777-0921
Mailing Address - Fax:
Practice Address - Street 1:6720 VALLEY CIRCLE BLVD
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2809
Practice Address - Country:US
Practice Address - Phone:747-777-0921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2044182471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography