Healthcare Provider Details

I. General information

NPI: 1518554377
Provider Name (Legal Business Name): BABIESMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2020
Last Update Date: 12/28/2020
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WESTON
IRVINE CA
92620-2190
US

IV. Provider business mailing address

82 WESTON
IRVINE CA
92620-2190
US

V. Phone/Fax

Practice location:
  • Phone: 817-564-5750
  • Fax: 817-612-3268
Mailing address:
  • Phone: 817-564-5750
  • Fax: 817-612-3268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: RASHMI JAIN
Title or Position: PRESIDENT
Credential: MD
Phone: 817-564-5750