Provider Demographics
NPI:1053386243
Name:MESHKINPOUR, HOOSHANG (MD)
Entity type:Individual
Prefix:DR
First Name:HOOSHANG
Middle Name:
Last Name:MESHKINPOUR
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 1:16100 SAND CANYON AVE
Mailing Address - Street 2:#260
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3716
Mailing Address - Country:US
Mailing Address - Phone:949-417-1100
Mailing Address - Fax:949-387-3051
Practice Address - Street 1:16100 SAND CANYON AVE
Practice Address - Street 2:#260
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3716
Practice Address - Country:US
Practice Address - Phone:949-417-1100
Practice Address - Fax:949-387-3051
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG25211207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24325Medicare UPIN
CAWA25211DMedicare ID - Type Unspecified