Individual
DR. KENNETH KAMBIZ GHEYSAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23046 AVENIDA DE LA CARLOTA STE 600, LAGUNA HILLS, CA 92653-1537
(949) 306-2566
Mailing address
23046 AVENIDA DE LA CARLOTA STE 600, LAGUNA HILLS, CA 92653-1537
(949) 306-2566
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
G 71924
CA
Other
Enumeration date
03/22/2007
Last updated
04/29/2022
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