MEDICARE: POUYA AFSHAR MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1689978983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POUYA AFSHAR MD INC

Provider Business Mailing Address
First Line	:	7801 MISSION CENTER CT STE 310
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1316
Country	:	US
Telephone Number	:	619-795-8346
Fax Number	:

Provider Business Practice Location Address
First Line	:	7801 MISSION CENTER CT STE 310
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1316
Country	:	US
Telephone Number	:	619-795-8346
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	POUYA AFSHAR
Credential	:	M.D.
Telephone Number	:	619-795-8346

Provider Enumeration Date	:	12/29/2010
Last Update Date	:	06/01/2016

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