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General NPI Number Information
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NPI Number | 1942580543
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Entity Type | Organization
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Legal Business Name | ATA M. KASHANI MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 18355 SHERMAN WAY
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City | RESEDA
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State | CA
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Zip | 91335-4436
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Country | US
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Telephone | 818-343-0964
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Fax | 818-343-0768
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Provider Business Mailing Address
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Address Line | 18355 SHERMAN WAY
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City | RESEDA
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State | CA
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Zip | 91335-4436
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Country | US
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Telephone | 818-343-0964
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Fax | 818-343-0768
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Authorized Official
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Title or Position | PRESIDENT
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Name | ATA M KASHANI
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Credential | MD
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Telephone | 818-343-0964
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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 | A41464
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License Number State | CA
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