Fred Khonsari Medical Corporation

NPI #1275734410 in Orange, California

Provider Information

NPI Number: 1275734410
Entity Type: Organization
Organization Name: Fred Khonsari Medical Corporation
Primary Specialty: Urology
Enumeration Date: May 29, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1140 W LA VETA AVE
Address 2: SUITE # 605
City: Orange
State: California
ZIP Code: 92868-4223
Phone: (714) 547-7457

Authorized Official

Name: DR. FERAIDOUN KHONSARI, M.D.
Title: CORPORATION PRESIDENT
Phone: (714) 547-7457

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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