Khorsan, Reza

Khorsan, Reza is an individual health care provider with primary practice located at 1245 16Th St Ste 309 , Santa Monica CA 90404-1239. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Khorsan, Reza can be contacted via phone (310) 319-4371.

Contact Information

Primary practice address
1245 16Th St Ste 309 Santa Monica CA 90404-1239
Phone: (310) 319-4371
Fax: (310) 319-4141
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A101659 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A101659 California

Profile Details

NPI number 1356536585
LBN Legal business name Khorsan, Reza
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2007
Last updated Sep 12th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356536585 NPPES
California MEDICAID 1356536585

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