Organization
MATT REZA KHOSHNEVIS MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA QUINONEZ (OFFICE MANAGER)
(562) 626-8016
Entity
Organization
Contact information
Practice address
3851 KATELLA AVE, SUITE 315, LOS ALAMITOS, CA 90720-3309
(562) 626-8016
Mailing address
3851 KATELLA AVE, SUITE 315, LOS ALAMITOS, CA 90720-3309
(562) 626-8016
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215032305
INDIVIDUAL NPI
TX
Enumeration date
09/18/2015
Last updated
02/17/2016
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