Healthcare Provider Details

I. General information

NPI: 1326079765
Provider Name (Legal Business Name): AMIR MASOUD KARAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AMIR MASOUD KARAMZADEH M.D.

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11394 CADENCE GROVE WAY
SAN DIEGO CA
92130
US

IV. Provider business mailing address

11394 CADENCE GROVE WAY
SAN DIEGO CA
92130
US

V. Phone/Fax

Practice location:
  • Phone: 714-390-0985
  • Fax: 858-856-9291
Mailing address:
  • Phone: 714-390-0985
  • Fax: 858-856-9291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberA82484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: