Healthcare Provider Details

I. General information

NPI: 1275443525
Provider Name (Legal Business Name): KEEMIA MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23141 VERDUGO DR STE 201
LAGUNA HILLS CA
92653-1341
US

IV. Provider business mailing address

23141 VERDUGO DR STE 201
LAGUNA HILLS CA
92653-1341
US

V. Phone/Fax

Practice location:
  • Phone: 949-215-5055
  • Fax:
Mailing address:
  • Phone: 949-215-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALI MOJAVERIAN
Title or Position: OWNER CEO
Credential: MD
Phone: 949-215-5055