Provider Demographics
NPI:1144276262
Name:KAVIANI, AMIR (MD)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:KAVIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23451 MADISON ST
Mailing Address - Street 2:SUITE #340
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4763
Mailing Address - Country:US
Mailing Address - Phone:310-373-6864
Mailing Address - Fax:310-373-9547
Practice Address - Street 1:23451 MADISON ST
Practice Address - Street 2:SUITE #340
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4763
Practice Address - Country:US
Practice Address - Phone:310-373-6864
Practice Address - Fax:310-373-9547
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA686552086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery