Provider Demographics
NPI:1720321318
Name:KAVIANI, ASHKHAN NICHOLAS
Entity type:Individual
Prefix:
First Name:ASHKHAN
Middle Name:NICHOLAS
Last Name:KAVIANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ASHY
Other - Middle Name:
Other - Last Name:KAVIANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:7301 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307
Mailing Address - Country:US
Mailing Address - Phone:818-264-3344
Mailing Address - Fax:818-264-3433
Practice Address - Street 1:7301 MEDICAL CENTER DR STE 400
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1988
Practice Address - Country:US
Practice Address - Phone:818-264-3344
Practice Address - Fax:818-264-3433
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical