Individual
KIARASH KHAJAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2141 N HARBOR BLVD, SUITE 35000, FULLERTON, CA 92835-3827
(714) 626-8630
(714) 626-8659
Mailing address
2141 N HARBOR BLVD STE 35000, FULLERTON, CA 92835-3831
(714) 626-8630
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A76316
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A76316
LICENSE
CA
Enumeration date
10/31/2006
Last updated
09/01/2020
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