Individual
DARYOUSH KHOSHROU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 N TUSTIN AVE, SUITE 101, SANTA ANA, CA 92705-3612
(714) 558-1310
(714) 558-1320
Mailing address
801 N TUSTIN AVE, SUITE 101, SANTA ANA, CA 92705-3612
(714) 558-1310
(714) 558-1320
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A49539
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A495390
—
CA
Enumeration date
10/18/2006
Last updated
10/13/2021
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