Healthcare Provider Details

I. General information

NPI: 1750321568
Provider Name (Legal Business Name): KAMYAR ASSIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32144 AGOURA RD STE 204
WESTLAKE VILLAGE CA
91361-4050
US

IV. Provider business mailing address

32144 AGOURA RD STE 204
WESTLAKE VILLAGE CA
91361-4050
US

V. Phone/Fax

Practice location:
  • Phone: 805-241-0151
  • Fax: 805-241-0161
Mailing address:
  • Phone: 805-241-0151
  • Fax: 805-241-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberG81184
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberG81184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: