Organization
BENJAMIN J. KAVOOSSI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN J. KAVOOSSI M.D. (PRESIDENT)
(909) 985-2112
Entity
Organization
Contact information
Practice address
2720 N GAREY AVE, POMONA, CA 91767-1810
(909) 593-6222
Mailing address
PO BOX 148, CLAREMONT, CA 91711-0148
(909) 985-2112
(909) 985-3411
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A94166
CA
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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