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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063114759

Kianoush Kenneth Soofi, DO is a Student in an Organized Health Care Education/Training Program in Riverside, California. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone: (951) 788-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1063114759
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 20, 2023
Last updated in NPPESMarch 20, 2023
Certification dateMarch 18, 2023
Mailing address43 Via Bandada, Rancho Santa Margarita, CA 92688-3434

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