Healthcare Provider Details

I. General information

NPI: 1245388289
Provider Name (Legal Business Name): AFSHIN RASHTIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 BROCKTON AVE STE 101
RIVERSIDE CA
92501-4027
US

IV. Provider business mailing address

4500 BROCKTON AVE STE 101
RIVERSIDE CA
92501-4027
US

V. Phone/Fax

Practice location:
  • Phone: 951-786-5501
  • Fax: 951-788-4796
Mailing address:
  • Phone: 951-786-5501
  • Fax: 951-788-4796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA87539
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: