Provider Demographics
NPI:1336305036
Name:ASHOURI, ANOUSHEH (MD)
Entity type:Individual
Prefix:
First Name:ANOUSHEH
Middle Name:
Last Name:ASHOURI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6926 BROCKTON AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3804
Mailing Address - Country:US
Mailing Address - Phone:877-414-7739
Mailing Address - Fax:844-682-0372
Practice Address - Street 1:6926 BROCKTON AVE STE 8
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3804
Practice Address - Country:US
Practice Address - Phone:877-414-7739
Practice Address - Fax:844-682-0372
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113709207R00000X, 208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics