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KOUROSH KHAMOOSHIAN MD PC
NPI 1194079632
Clinic/Center - Community Health in La Mesa, CA

Active since November 06, 2012CLIA 05D2317389 · Waiver
5565 GROSSMONT CENTER DR STE 444, LA MESA, CA 91942(858) 373-9616(858) 373-9619 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 1, 2025, Sep 5, 2024 (2 updates tracked since 2024).

About Kourosh Khamooshian Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOUROSH KHAMOOSHIAN MD PC (NPI 1194079632) is a healthcare organization registered as a community health in La Mesa, California and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through January 22, 2027 and lists Kourosh Khamooshian, Owner / Ceo, as its authorized official.

NPPES Registry Identity

NPI1194079632
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameKOUROSH KHAMOOSHIAN MD PC
Location Address5565 GROSSMONT CENTER DR STE 444La Mesa, CA 91942-3020
Mailing Address5565 Grossmont Center Dr Ste 444La Mesa, CA 91942-3020 · (858) 373-9616 · Fax (858) 373-9619
Phone(858) 373-9616
Fax(858) 373-9619
Organization SubpartNo
Authorized OfficialKourosh KhamooshianOwner / Ceo · (858) 373-9616
Enumeration DateNovember 6, 2012
Last NPPES UpdateJuly 1, 20252 updates tracked since enumeration
NPPES CertifiedJuly 1, 2025
✔ NPI 1194079632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
License✔ Licensed in CA · A110901
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
5565 GROSSMONT CENTER DR STE 444, La Mesa, CA 91942
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2317389

Kourosh Khamooshian MD, PC Dba Khamooshian Wellhaven Medical Clinic · La Mesa, CA
Active · expires Jan 22, 2027
CLIA Number05D2317389
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2025
Certificate Expiration DateJanuary 22, 2027
Laboratory DirectorKourosh Khamooshian
Laboratory Phone(619) 698-0606
Laboratory LocationKourosh Khamooshian MD, PC Dba Khamooshian Wellhaven Medical Clinic5565 Grossmont Center Dr Bldg 3 Ste 444, La Mesa, CA 91942
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KOUROSH KHAMOOSHIAN MD
Internal Medicine
5565 GROSSMONT CENTER DR STE 444
LA MESA, CA 91942
San Diego County (888) 475-6662
DR. NARGES BALUCH MD
Allergy & Immunology
5565 GROSSMONT CENTER DR STE 444
LA MESA, CA 91942
San Diego County (858) 226-8805

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kourosh Khamooshian MD PC's NPI number?

The NPI number for Kourosh Khamooshian MD PC is 1194079632. It was assigned to this organization in the NPPES registry on November 6, 2012.

Where is Kourosh Khamooshian MD PC located?

Kourosh Khamooshian MD PC is located at 5565 Grossmont Center Dr Ste 444, La Mesa, CA 91942. The listed phone number is (858) 373-9616.

What is Kourosh Khamooshian MD PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Kourosh Khamooshian MD PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2317389) is associated with this NPI, valid through January 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kourosh Khamooshian MD PC was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.