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Organization
KOUROSH KHAMOOSHIAN MD PC
Active
Organization
KOUROSH KHAMOOSHIAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOUROSH KHAMOOSHIAN MD (OWNER / CEO)
(858) 373-9616
Entity
Organization
Contact information
Practice address
5565 GROSSMONT CENTER DR STE 444, LA MESA, CA 91942-3020
(858) 373-9616
(858) 373-9619
Mailing address
5565 GROSSMONT CENTER DR STE 444, LA MESA, CA 91942-3020
(858) 373-9616
(858) 373-9619
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
A110901
CA
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
11/06/2012
Last updated
07/01/2025
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