MEDICARE: DR. KAVEH SOLEIMANPOUR M.D.

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
1	2085N0904X	Nuclear Radiology Physician	A91640	CA
2	2085R0202X	Diagnostic Radiology Physician	A91640	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD034705	OTHER	DC	MEDICAL LICENSE NUMBER
2	A91640	OTHER	CA	MEDICAL LICENSE NUMBER
3	MD424373	OTHER	PA	MEDICAL LICENSE NUMBER

General Provider Information

NPI Number	:	1104923572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAVEH SOLEIMANPOUR M.D.

Provider Business Mailing Address
First Line	:	3949 LOS FELIZ BLVD.
Second Line	:	APT. 611
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2324
Country	:	US
Telephone Number	:	323-661-6961
Fax Number	:	323-664-6506

Provider Business Practice Location Address
First Line	:	3949 LOS FELIZ BLVD.
Second Line	:	APT. 611
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2324
Country	:	US
Telephone Number	:	323-661-6961
Fax Number	:	323-664-6506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/11/2025

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