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

Tina Khosravi

Individual provider Medical Physician Assistant · NPI 1609301506

Tina Khosravi is a Medical Physician Assistant in Orange, California. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

705 W La Veta Ave Ste 109
Orange, CA 92868-4447
Phone: (714) 628-9342
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1609301506
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 27, 2017
Last updated in NPPESNovember 27, 2017
Mailing address705 W La Veta Ave Ste 109, Orange, CA 92868-4447

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