Provider Demographics
NPI:1124035902
Name:AFLATOON, KAMRAN (DO)
Entity type:Individual
Prefix:MR
First Name:KAMRAN
Middle Name:
Last Name:AFLATOON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 CAMPUS DR
Mailing Address - Street 2:STE 104
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2603
Mailing Address - Country:US
Mailing Address - Phone:949-645-7746
Mailing Address - Fax:949-645-7749
Practice Address - Street 1:3700 CAMPUS DR
Practice Address - Street 2:STE 104
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2603
Practice Address - Country:US
Practice Address - Phone:949-645-7746
Practice Address - Fax:949-645-7749
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8503207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA610702700OtherDEPT OF LABOR
CAH31468Medicare UPIN
CA20A8503Medicare ID - Type Unspecified