Dr. Kenneth Kambiz Gheysar
Family Doctor - Addiction Medicine
1100 S Coast Hwy Suite 204
Laguna Beach
, California 92651-2968
Dr. Kenneth Kambiz Gheysar
Family Doctor - Addiction Medicine
1100 S Coast Hwy Suite 204
Laguna Beach
, California 92651-2968
(949) 306-2566
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About
Features
Specialties
- Family Doctor - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. Kenneth Kambiz Gheysar
- 3215 Vista Pacifica
- Vista, CA
- Zip : 92084-6646
- Phone : (949) 306-2566
Second Address
- Dr. Kenneth Kambiz Gheysar
- 1100 S Coast Hwy Suite 204
- Laguna Beach, CA
- Zip : 92651-2968
- Phone : (949) 306-2566
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Is Dr. Kenneth Kambiz Gheysar accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0401X | Family Doctor - Addiction Medicine | G 71924 | CA |
National Provider Identifier
| NPI | 1609992171 |
|---|---|
| Provider Name | Dr. Kenneth Kambiz Gheysar |
| First Address | Vista, CA 92084-6646 |
| Second Address | Laguna Beach, CA 92651-2968 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/03/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.