Individual
DR. KIAN RAISZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2725 RIDGEGATE ROW, LA JOLLA, CA 92037-0915
(201) 600-4903
Mailing address
2725 RIDGEGATE ROW, LA JOLLA, CA 92037-0915
(201) 600-4903
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A99221
CA
Other
Enumeration date
07/18/2007
Last updated
10/13/2021
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