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NPI Code Detail

MEDICARE: JASMIN KOUHKAN

MEDICARE: JASMIN KOUHKAN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1134891989
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMIN KOUHKAN
Provider Business Mailing Address
First Line : 17391 E SANTA CLARA AVE
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-1865
Country : US
Telephone Number : 714-609-0282
Fax Number :
Provider Business Practice Location Address
First Line : 2526 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94704-2607
Country : US
Telephone Number : 510-519-8041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2021
Last Update Date : 09/11/2025

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Directions to “ JASMIN KOUHKAN ” Practice Location

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