Provider Demographics
NPI:1316125909
Name:KASHANI, AMIR
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:KASHANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SEYEDAMIR
Other - Middle Name:
Other - Last Name:KASHANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:30 N 1900 E # 4R118
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0002
Mailing Address - Country:US
Mailing Address - Phone:801-585-0553
Mailing Address - Fax:
Practice Address - Street 1:30 N 1900 E # 4R118
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132
Practice Address - Country:US
Practice Address - Phone:801-585-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11313928-1205207RG0100X
CAA111882207R00000X
TNMD56616207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEG594ZMedicaid