Healthcare Provider Details

I. General information

NPI: 1427007277
Provider Name (Legal Business Name): ELHAM TAEED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BARRANCA PKWY STE 308
IRVINE CA
92604-4631
US

IV. Provider business mailing address

4950 BARRANCA PKWY STE 308
IRVINE CA
92604-4631
US

V. Phone/Fax

Practice location:
  • Phone: 949-548-5700
  • Fax: 949-548-5703
Mailing address:
  • Phone: 495-485-7009
  • Fax: 492-880-2549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA54363
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: