Provider Demographics
NPI:1952516304
Name:KARIMIAN, MERSEDEH (DO)
Entity Type:Individual
Prefix:DR
First Name:MERSEDEH
Middle Name:
Last Name:KARIMIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18400 US HIGHWAY 18
Mailing Address - Street 2:SUITE A
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2306
Mailing Address - Country:US
Mailing Address - Phone:760-242-3939
Mailing Address - Fax:760-242-3232
Practice Address - Street 1:18400 US HIGHWAY 18
Practice Address - Street 2:SUITE A
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2306
Practice Address - Country:US
Practice Address - Phone:760-242-3939
Practice Address - Fax:760-242-3232
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2012-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9115207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAV381ZOtherMEDICARE INDIV GRP PIN
CAAV381ZOtherMEDICARE INDIV GRP PIN
CAAV381YMedicare PIN