MEDICARE: ALI KHOYNEZHAD MD

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	204F00000X	Transplant Surgery Physician	23507	NE
2	208600000X	Surgery Physician	A92674	CA
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	A92674	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	:	1659329209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI KHOYNEZHAD MD

Provider Business Mailing Address
First Line	:	3828 SCHAUFELE AVE STE 340
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-1793
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3828 SCHAUFELE AVE STE 340
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-1793
Country	:	US
Telephone Number	:	562-427-5388
Fax Number	:

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/28/2017

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Directions to “ ALI KHOYNEZHAD MD” Practice Location

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