Dr Kourosh Darren Bagheri, MD, MS is a
Internal Medicine physician based in Shell Beach, California. Dr Kourosh Darren Bagheri is licensed to practice in California (license number G77496) and his current practice location is 170 Seacliff Dr, Shell Beach, California. He can be reached at his office (for appointments etc.) via phone at
(805) 781-9111.
NPI number for Dr Kourosh Darren Bagheri is 1457540031 and his current mailing address is 1177 Marsh St Ste 100, San Luis Obispo, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1457540031.
Physician's Profile
| Full Name | Dr Kourosh Darren Bagheri |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 170 Seacliff Dr, Shell Beach, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1457540031
- Provider Enumeration Date: 10/18/2007
- Last Update Date: 12/28/2022
Medical Identifiers
Medical identifiers for Dr Kourosh Darren Bagheri such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457540031 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | G77496 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kourosh Darren Bagheri is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kourosh Darren Bagheri, MD, MS
1177 Marsh St Ste 100,
San Luis Obispo, CA 93401-2316
Ph: (805) 781-9111 | Dr Kourosh Darren Bagheri, MD, MS
170 Seacliff Dr,
Shell Beach, CA 93449-1715
Ph: (805) 781-9111 |
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