Provider Demographics
NPI:1093034860
Name:KASHANCHI, MORVARIED P
Entity type:Individual
Prefix:MRS
First Name:MORVARIED
Middle Name:P
Last Name:KASHANCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29123 WHITES POINT DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-4641
Mailing Address - Country:US
Mailing Address - Phone:310-377-4512
Mailing Address - Fax:
Practice Address - Street 1:29123 WHITES POINT DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-4641
Practice Address - Country:US
Practice Address - Phone:310-377-4512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies