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General NPI Number Information
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NPI Number | 1235096629
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Entity Type | Individual
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Provider Name | DEZIRE KHOSRAVI
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 8357 FLORENCE AVE
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City | DOWNEY
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State | CA
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Zip | 90240-3928
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Country | US
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Telephone | 661-998-6728
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Fax |
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Provider Business Mailing Address
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Address Line | 6720 VALLEY CIRCLE BLVD
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City | WEST HILLS
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State | CA
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Zip | 91307-2809
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN95376376
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License Number State | CA
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