Healthcare Provider Details

I. General information

NPI: 1275665515
Provider Name (Legal Business Name): HOSSEIN KANI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HOSSEIN KANI M.D

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 W 17TH ST SUITE A
SANTA ANA CA
92706-3335
US

IV. Provider business mailing address

1629 W 17TH ST SUITE A
SANTA ANA CA
92706-3335
US

V. Phone/Fax

Practice location:
  • Phone: 714-972-2111
  • Fax: 714-972-2045
Mailing address:
  • Phone: 714-972-2111
  • Fax: 714-972-2045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA45925
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: