Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 20A11542 | CA |
Y | 111NI0900X | Internist | 20A11542 | CA |
N | 207RG0300X | Geriatric Medicine | 718 | NV |
NPI | 1053451328 |
---|---|
Provider Name | Dr. Kian Kaveh |
First Address | Las Vegas, NV 89118-2554 |
Second Address | Turlock, CA 95382-1148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 03/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F65989 | (02) | NV |