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General NPI Number Information
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NPI Number | 1912359605
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Entity Type | Individual
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Provider Name | KAVEN HOSSEINZADEH
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Gender | Male
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 28062 BAXTER RD
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City | MURRIETA
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State | CA
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Zip | 92563-1401
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Country | US
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Telephone | 714-906-5465
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A162719
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A162719
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125069670
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License Number State | IL
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