Provider Demographics
NPI:1982579215
Name:ASPIRE HEALTH MSO LLC
Entity type:Organization
Organization Name:ASPIRE HEALTH MSO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATIBI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-842-9628
Mailing Address - Street 1:29911 NIGUEL RD UNIT 6429
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-2417
Mailing Address - Country:US
Mailing Address - Phone:949-842-9628
Mailing Address - Fax:888-873-6220
Practice Address - Street 1:14390 CIVIC DR
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-9709
Practice Address - Country:US
Practice Address - Phone:888-873-6220
Practice Address - Fax:888-873-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain