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NPI Code Detail

MEDICARE: CAMERON KHAVRIAN, MD INC

MEDICARE: CAMERON KHAVRIAN, MD INC
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
1207R00000XInternal Medicine PhysicianA79842CA

General Provider Information

NPI Number : 1528138823
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMERON KHAVRIAN, MD INC
Provider Business Mailing Address
First Line : 320 SUPERIOR AVENUE
Second Line : SUITE 320
City : NEWPORT BEACH
State : CA
Zip : 92663-2742
Country : US
Telephone Number : 949-645-8475
Fax Number : 855-213-1762
Provider Business Practice Location Address
First Line : 320 SUPERIOR AVENUE
Second Line : SUITE 320
City : NEWPORT BEACH
State : CA
Zip : 92663-2742
Country : US
Telephone Number : 949-645-8475
Fax Number : 855-213-1762
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : DR. CAMERON KHAVARIAN
Credential : M.D.
Telephone Number : 949-645-8475
Provider Enumeration Date : 11/08/2006
Last Update Date : 01/31/2014

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Directions to “CAMERON KHAVRIAN, MD INC ” Practice Location

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