Healthcare Provider Details

I. General information

NPI: 1821670084
Provider Name (Legal Business Name): HOJJAT MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 WATERWORKS WAY STE 100
IRVINE CA
92618-3171
US

IV. Provider business mailing address

7 MORNING VW
IRVINE CA
92603-3716
US

V. Phone/Fax

Practice location:
  • Phone: 949-996-3274
  • Fax:
Mailing address:
  • Phone: 949-996-3274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HOUMEHR HOJJAT
Title or Position: OWNER / PRESIDENT
Credential: MD
Phone: 949-996-3274