Individual
DR. KAMRAN GHODSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24502 PACIFIC PARK DR, SUITE 105, ALISO VIEJO, CA 92656-3033
(949) 362-1515
(949) 362-7548
Mailing address
24502 PACIFIC PARK DR, SUITE 105, ALISO VIEJO, CA 92656-3033
(949) 362-1515
(949) 362-7548
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A41039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A410390
—
CA
Enumeration date
06/10/2005
Last updated
01/26/2012
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