Healthcare Provider Details

I. General information

NPI: 1659020568
Provider Name (Legal Business Name): MORCEL HAMIDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2022
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CORPORATE DR STE 200
LADERA RANCH CA
92694-2179
US

IV. Provider business mailing address

2441 W LA PALMA AVE STE 100
ANAHEIM CA
92801-2661
US

V. Phone/Fax

Practice location:
  • Phone: 949-347-7200
  • Fax:
Mailing address:
  • Phone: 657-282-6356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number189681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: