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NPI Code Detail

MEDICARE: MEHRAN MOUSSAVIAN DO

MEDICARE: MEHRAN MOUSSAVIAN DO
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
1207RC0000XCardiovascular Disease Physician20A7241CA
2207RI0011XInterventional Cardiology Physician20A7241CA

General Provider Information

NPI Number : 1689788234
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEHRAN MOUSSAVIAN DO
Provider Business Mailing Address
First Line : 754 MEDICAL CENTER CT
Second Line : SUITE 204
City : CHULA VISTA
State : CA
Zip : 91911-6654
Country : US
Telephone Number : 619-616-2100
Fax Number : 619-616-2104
Provider Business Practice Location Address
First Line : 765 MEDICAL CENTER CT STE 211
Second Line :
City : CHULA VISTA
State : CA
Zip : 91911-6600
Country : US
Telephone Number : 619-616-2100
Fax Number : 619-616-2104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 05/13/2022

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Directions to “ MEHRAN MOUSSAVIAN DO” Practice Location

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