Healthcare Provider Details

I. General information

NPI: 1386847531
Provider Name (Legal Business Name): DARYOUSH KASHANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8727 VAN NUYS BLVD 101
PANORAMA CITY CA
91402-2451
US

IV. Provider business mailing address

6609 VAN NUYS BLVD # 201
VAN NUYS CA
91405-4618
US

V. Phone/Fax

Practice location:
  • Phone: 818-899-5555
  • Fax: 818-899-5969
Mailing address:
  • Phone: 818-899-5555
  • Fax: 818-899-5969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA66698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: