Provider Demographics
NPI:1437288073
Name:KARIMIAN, SIAVASH (MD, ABFM)
Entity type:Individual
Prefix:DR
First Name:SIAVASH
Middle Name:
Last Name:KARIMIAN
Suffix:
Gender:M
Credentials:MD, ABFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 N. WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201
Mailing Address - Country:US
Mailing Address - Phone:575-625-8430
Mailing Address - Fax:575-625-8452
Practice Address - Street 1:72650 FRED WARING DR STE 106
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5007
Practice Address - Country:US
Practice Address - Phone:760-230-9990
Practice Address - Fax:760-636-1270
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0234207Q00000X
CAA98867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine