Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chayanne Khosravi

Individual provider Internal Medicine Physician · NPI 1134682610

Chayanne Khosravi is a Pulmonary Disease in Colton, California. Qualified in 2019, 7 years ago. Practices with Mesa Pulmonary Group Inc, a 6-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2019
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Practice location Address checks out

400 N Pepper Ave
Colton, CA 92324-1801
Phone: (909) 580-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence A180382 (CA)

Record details

NPI number1134682610
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 10, 2019
Last updated in NPPESAugust 29, 2024
Certification dateAugust 29, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPULMONARY DISEASE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mesa Pulmonary Group Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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