Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A92888 | CA |
Y | 111NI0900X | Internist | A92888 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | A92888 | CA |
NPI | 1003892282 |
---|---|
Provider Name | Dr. Pouria Kashkouli |
First Address | Sacramento, CA 95817-1460 |
Second Address | Sacramento, CA 95817-1460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 22/04/2014 |