MEDICARE: DR. PARISA KHAVARI 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	207V00000X	Obstetrics & Gynecology Physician	G181173	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1346226180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARISA KHAVARI M.D.

Provider Business Mailing Address
First Line	:	627 EASTLAND AVE SE STE 302
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-4501
Country	:	US
Telephone Number	:	330-841-4975
Fax Number	:	330-841-4979

Provider Business Practice Location Address
First Line	:	627 EASTLAND AVE SE STE 302
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-4501
Country	:	US
Telephone Number	:	330-841-4975
Fax Number	:	330-841-4979

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	01/31/2025

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