# MASTANEH NIKRAVESH MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982585980
- **Authorized official:** DR. MASTANEH NIKRAVESH MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (619) 869-9953

## Contact information

- **Practice address:** 7901 FROST ST, SAN DIEGO, CA 92123-2701
- **Practice address phone:** (619) 940-7934
- **Mailing address:** 600 1ST AVE STE 102-2405, SEATTLE, WA 98104-2210
- **Mailing address phone:** (619) 940-7934

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2025
- **Last updated:** 09/08/2025