Healthcare Provider Details

I. General information

NPI: 1528879244
Provider Name (Legal Business Name): ANOUSHEH ASHOURI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RAKE
IRVINE CA
92618-0827
US

IV. Provider business mailing address

6926 BROCKTON AVE STE 8
RIVERSIDE CA
92506-3804
US

V. Phone/Fax

Practice location:
  • Phone: 877-414-7739
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: ANOUSHEH ASHOURI
Title or Position: OWNER
Credential:
Phone: 818-480-1418