Vakhshouri, Khosrow

Vakhshouri, Khosrow is an individual health care provider with primary practice located at 2151 W Grant Line Rd , Tracy CA 95377-7309. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Vakhshouri, Khosrow can be contacted via phone (209) 832-0535.

Contact Information

Primary practice address
2151 W Grant Line Rd Tracy CA 95377-7309
Phone: (209) 832-0535
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A87152 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A87152 California

Profile Details

NPI number 1215993456
LBN Legal business name Vakhshouri, Khosrow
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Feb 24th, 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 1215993456 NPPES
California MEDICAID 00A871520

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