Ebrahimzadeh, Khashayar

Ebrahimzadeh, Khashayar is an sole proprietor health care provider with primary practice located at 1415 W Hobsonway , Blythe CA 92225-1479. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ebrahimzadeh, Khashayar can be contacted via phone (760) 922-4981.

Contact Information

Primary practice address
1415 W Hobsonway Blythe CA 92225-1479
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4351045098 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A176374 California

Profile Details

NPI number 1770144016
LBN Legal business name Ebrahimzadeh, Khashayar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2019
Last updated Feb 7th, 2025 - about last year

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 1770144016 NPPES
Michigan MEDICAID 4351045098

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