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Organization
MASTANEH NIKRAVESH MD PC
Active
Organization
MASTANEH NIKRAVESH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASTANEH NIKRAVESH MD (PHYSICIAN/OWNER)
(619) 869-9953
Entity
Organization
Contact information
Practice address
7901 FROST ST, SAN DIEGO, CA 92123-2701
(619) 940-7934
Mailing address
600 1ST AVE STE 102-2405, SEATTLE, WA 98104-2210
(619) 940-7934
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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