Individual
KIAN KAVIANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0055938
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090804500
—
MD
01
—
0K88K
BLUE CROSS BLUE SHIELD
MD
01
—
287102
MAMSI APO
—
01
—
887102
MAMSI HMO
—
Enumeration date
06/17/2006
Last updated
05/27/2008
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