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General NPI Number Information
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NPI Number | 1861428104
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Entity Type | Individual
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Provider Name | KAYVAN BINAEI PA
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Gender | Male
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 3549 CAMINO DEL RIO S SUITE A
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City | SAN DIEGO
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State | CA
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Zip | 92108-4023
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Country | US
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Telephone | 619-543-0144
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Fax | 619-543-0445
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Provider Business Mailing Address
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Address Line | 7244 SHORELINE DR UNIT 144 UNIT 144
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City | SAN DIEGO
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State | CA
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Zip | 92122-4932
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Country | US
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Telephone | 619-543-0144
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Fax | 619-543-0445
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA 16285
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License Number State | CA
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