CAMERON KAVOOSI MD
NPI 1336934181
Student in an Organized Health Care Education/Training Program in San Bernardino, CA

Q: What is Cameron Kavoosi's NPI number?

The NPI number for Cameron Kavoosi is 1336934181. It was assigned to this individual provider in the NPPES registry on April 11, 2025.

Q: What is Cameron Kavoosi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Cameron Kavoosi was last updated on May 30, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 11, 2025PECOS Enrolled

2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404(949) 633-0670 Get Directions Write a Review

NPPES record last updated: May 30, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 30, 2026, Apr 11, 2025 (2 updates tracked since 2025).

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About Cameron Kavoosi Md NPPES

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

CAMERON KAVOOSI MD (NPI 1336934181) is an individual student in an organized health care education/training program in San Bernardino, California and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS and maintains a secondary practice location in Shreveport.

NPPES Registry Identity

NPI1336934181

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameCAMERON KAVOOSICredential: MD

Location Address2101 N WATERMAN AVESan Bernardino, CA 92404-4836

Mailing Address1501 Kings HwyShreveport, LA 71103-4228 · (949) 633-0670

Phone(949) 633-0670

Sole ProprietorNo

Enumeration DateApril 11, 2025

Last NPPES UpdateMay 30, 20262 updates tracked since enumeration

NPPES CertifiedMay 30, 2026

✔ NPI 1336934181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2101 N WATERMAN AVE, San Bernardino, CA 92404

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Secondary Practice Location 1

Location 11501 Kings HwyShreveport, LA 71103-4228 · Phone (318) 626-2326

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cameron Kavoosi Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

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

NICHOLAS WALTHER PA-C

Physician Assistant (Medical)