Healthcare Provider Details
I. General information
NPI: 1972914133
Provider Name (Legal Business Name): HASAN BADDAY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2014
Last Update Date: 10/11/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22 ODYSSEY SUITE 165
IRVINE CA
92618-3194
US
IV. Provider business mailing address
5 HOLLAND SUITE 101
IRVINE CA
92618-2568
US
V. Phone/Fax
- Phone: 949-872-2632
- Fax: 949-258-5011
- Phone: 949-588-2190
- Fax: 949-588-2199
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HASAN
BADDAY
Title or Position: OWNER
Credential: MD
Phone: 949-872-2632