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NPI Code Detail

MEDICARE: ARDAVAN M AFSHAR MD

MEDICARE: ARDAVAN M AFSHAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianA70746CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2A7007461OTHERCARRMGI

General Provider Information

NPI Number : 1063413920
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARDAVAN M AFSHAR MD
Provider Business Mailing Address
First Line : PO BOX 15648
Second Line :
City : SACRAMENTO
State : CA
Zip : 95852-0648
Country : US
Telephone Number : 951-781-2270
Fax Number : 851-781-2293
Provider Business Practice Location Address
First Line : 4445 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-4135
Country : US
Telephone Number : 951-755-3400
Fax Number : 951-788-3194
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 08/15/2008

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Directions to “ ARDAVAN M AFSHAR MD” Practice Location

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