Individual
ARAM ADAM KHADIVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1223 26TH ST, SAN DIEGO, CA 92102-1005
(818) 292-1106
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(818) 292-1106
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
1750058046
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/25/2021
Last updated
02/14/2022
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