Mortazavi, Koosha

Mortazavi, Koosha is an individual health care provider with primary practice located at 1200 W Gonzales Rd Suite 300, Oxnard CA 93036-3072. 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. Mortazavi, Koosha can be contacted via phone (805) 278-9094.

Contact Information

Primary practice address
1200 W Gonzales Rd Suite 300 Oxnard CA 93036-3072
Fax: (805) 278-8964
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A91559 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A91559 California

Profile Details

NPI number 1215966999
LBN Legal business name Mortazavi, Koosha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jan 14th, 2010 - about 15 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 1215966999 NPPES
California MEDICAID ZZZ75566Z
California Other 110039977
California Other ZZZ34679Z

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