Healthcare Provider Details

I. General information

NPI: 1699389130
Provider Name (Legal Business Name): KASHEFI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST STE 110A
PASADENA CA
91106-2401
US

IV. Provider business mailing address

960 E GREEN ST STE 110A
PASADENA CA
91106-2401
US

V. Phone/Fax

Practice location:
  • Phone: 626-640-7474
  • Fax:
Mailing address:
  • Phone: 626-640-7474
  • Fax: 323-521-5021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: AMIR KASHEFI
Title or Position: OWNER
Credential: MD
Phone: 818-270-1280