Individual
KEIVON KIANFAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 480-4849
Mailing address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 480-4849
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2016-0091
NM
Other
Enumeration date
09/15/2016
Last updated
06/08/2023
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