Individual
KHASHAYAR KHOSRAVIANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 BICENTENNIAL WAY, DEPT OF RHEUMATOLOGY SUITE 160, SANTA ROSA, CA 95403-2149
(707) 393-4155
Mailing address
401 BICENTENNIAL WAY, DEPT OF RHEUMATOLOGY SUITE 160, SANTA ROSA, CA 95403-2149
(707) 393-4155
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
139927
CA
Other
Enumeration date
02/06/2012
Last updated
12/17/2021
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