Healthcare Provider Details

I. General information

NPI: 1306909403
Provider Name (Legal Business Name): HANI SALEHI-HAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7812 EDINGER AVE STE 202
HUNTINGTON BEACH CA
92647-3727
US

IV. Provider business mailing address

75 ENTERPRISE STE 200
ALISO VIEJO CA
92656-2626
US

V. Phone/Fax

Practice location:
  • Phone: 714-901-2006
  • Fax: 714-901-2004
Mailing address:
  • Phone: 949-688-6205
  • Fax: 949-688-6205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA107960
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberA107960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: