MEDICARE: DR. SIAVASH KARIMIAN MD, ABFM

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	207Q00000X	Family Medicine Physician	MD2007-0234	NM
2	207Q00000X	Family Medicine Physician	A98867	CA

General Provider Information

NPI Number	:	1437288073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIAVASH KARIMIAN MD, ABFM

Provider Business Mailing Address
First Line	:	1621 N. WASHINGTON AVENUE
Second Line	:
City	:	ROSWELL
State	:	NM
Zip	:	88201
Country	:	US
Telephone Number	:	575-625-8430
Fax Number	:	575-625-8452

Provider Business Practice Location Address
First Line	:	72650 FRED WARING DR STE 106
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-5007
Country	:	US
Telephone Number	:	760-230-9990
Fax Number	:	760-636-1270

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

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/18/2023

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