Organization
MASOUD KHORSAND- SAHBAIE MD P A
Active
Other names
Kymera Independent Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASOUD KHORSAND-SAHBAIE MD (OWNER)
(575) 627-9110
Entity
Organization
Contact information
Practice address
400 MILITARY HEIGHTS PL, ROSWELL, NM 88201-6407
(575) 627-9500
(877) 749-7764
Mailing address
PO BOX 1574, ROSWELL, NM 88202-1574
(575) 627-9508
(877) 749-7764
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
96299
NM
207RH0003X
Hematology & Oncology Physician
MD2007-0020
NM
207RH0003X
Hematology & Oncology Physician
MD2011-0742
NM
207RH0003X
Hematology & Oncology Physician
ST96299
NM
207RR0500X
Rheumatology Physician
MD2012-0244
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1238400001
PALMETTO GBA
NM
01
—
800521089
MEDICARE GROUP #
NM
01
—
Z2565
MEDICAID GROUP NUMBER
NM
Enumeration date
01/09/2006
Last updated
06/12/2023
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