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General NPI Number Information
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NPI Number | 1457557100
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Entity Type | Individual
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Provider Name | BABAK RAZAGHI KHAMSI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 6276 RIVER CREST DR
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City | RIVERSIDE
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State | CA
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Zip | 92507-0783
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Country | US
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Telephone | 951-413-0200
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Fax | 951-653-5680
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Provider Business Mailing Address
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Address Line | 6276 RIVER CREST DR
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City | RIVERSIDE
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State | CA
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Zip | 92507-0783
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Country | US
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Telephone | 951-413-0200
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Fax | 951-653-5680
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | A119808
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | A119808
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License Number State | CA
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