| Afshin Akhavan D.o., A Professional Corporation | |
|
530 E Washington Blvd Los Angeles CA 90015-3723 | |
| (213) 747-2626 | |
| (213) 749-7500 |
| Full Name | Afshin Akhavan D.o., A Professional Corporation |
|---|---|
| Speciality | General Practice |
| Location | 530 E Washington Blvd, Los Angeles, California |
| Authorized Official Name and Position | Afshin Akhavan (PRESIDENT AND MEDICAL DIRECTOR) |
| Authorized Official Contact | 3237301663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Afshin Akhavan D.o., A Professional Corporation 530 E Washington Blvd Los Angeles CA 90015-3723 Ph: (213) 747-2626 | Afshin Akhavan D.o., A Professional Corporation 530 E Washington Blvd Los Angeles CA 90015-3723 Ph: (213) 747-2626 |
| NPI Number | 1821210329 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 10/15/2014 |
| Medicare PECOS PAC ID | 3476516576 |
|---|---|
| Medicare Enrollment ID | O20041109001272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821210329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 20A7610 (California) | Primary |
| Provider Name | Afshin Akhavan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003952797 PECOS PAC ID: 4385607480 Enrollment ID: I20041112000285 |
| Provider Name | Jennifer Rae Knutson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770037715 PECOS PAC ID: 9739461989 Enrollment ID: I20170123002516 |
| Provider Name | Vicki P Cheng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255994216 PECOS PAC ID: 5799013199 Enrollment ID: I20190822003833 |
| Provider Name | Kimberly Frances Brinckerhoff-hakim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730774944 PECOS PAC ID: 5193124394 Enrollment ID: I20211102002198 |
| Provider Name | Elaine Minh Chau Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770241879 PECOS PAC ID: 4880088301 Enrollment ID: I20220228001075 |
| Provider Name | Myloan Tran Hoang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700568979 PECOS PAC ID: 8527416734 Enrollment ID: I20231129001202 |
| Provider Name | Vivien C Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811688591 PECOS PAC ID: 1254862485 Enrollment ID: I20240930000815 |
| Provider Name | Bonnie Lynn Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508690603 PECOS PAC ID: 2264960244 Enrollment ID: I20250106001060 |
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