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
Mailing address400 N Pepper Ave, Colton, CA 92324-1819

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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