| Kourosh Khamooshian M.d., P.c. | |
|
5555 Reservoir Dr Ste 303 San Diego CA 92120-5181 | |
| (858) 373-9616 | |
| (858) 373-9619 |
| Full Name | Kourosh Khamooshian M.d., P.c. |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 5555 Reservoir Dr Ste 303, San Diego, California |
| Authorized Official Name and Position | Kourosh Khamooshian (OWNER / CEO) |
| Authorized Official Contact | 8583739616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kourosh Khamooshian M.d., P.c. 5555 Reservoir Dr Ste 303 San Diego CA 92120-5181 Ph: (858) 373-9616 | Kourosh Khamooshian M.d., P.c. 5555 Reservoir Dr Ste 303 San Diego CA 92120-5181 Ph: (858) 373-9616 |
| NPI Number | 1194079632 |
|---|---|
| Provider Enumeration Date | 11/06/2012 |
| Last Update Date | 09/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194079632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | A110901 (California) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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