Fred Khonsari Medical Corporation

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

FRED KHONSARI MEDICAL CORPORATION

Practice address

1140 W la Veta Ave
Suite # 605
Orange, CA 92868-4223

Phone

(714) 547-7457

Fax

(714) 547-6202

NPI assigned

May 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Feraidoun Khonsari, M.D.NPI 1487612560

Title

Corporation President

Phone

(714) 547-7457

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Feraidoun Fred Khonsari, M.D.

  • Urology Physician
  • Orange, CA
  • NPI 1487612560
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275734410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE",
            "address_2": "SUITE # 605",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684223",
            "telephone_number": "714-547-7457",
            "fax_number": "714-547-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE",
            "address_2": "SUITE # 605",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684223",
            "telephone_number": "714-547-7457",
            "fax_number": "714-547-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED KHONSARI MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHONSARI",
        "authorized_official_first_name": "FERAIDOUN",
        "authorized_official_title_or_position": "CORPORATION PRESIDENT",
        "authorized_official_telephone_number": "714-547-7457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A310980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darriell Nykiya Franklin
• Jazmyne Lisa Dratay Franklin
• Elise Franks
• Megan Hope Franz
• Ana Laura Frasco
• Brian Earl Fredenburg, MFT
• Tanner Fredericksen
• Jamie N Frediani, M.D.
• Clair Fredriksz
• Linda Anne Freedkin, MS, LCGC

• Urology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.