Healthcare Provider Details
I. General information
NPI: 1831732791
Provider Name (Legal Business Name): SAEED ESHRAGHI, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2019
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1525 SUPERIOR AVE STE 214
NEWPORT BEACH CA
92663-3639
US
IV. Provider business mailing address
971 S JAY CIR
ANAHEIM CA
92808-2105
US
V. Phone/Fax
- Phone: 714-833-6281
- Fax: 949-326-0608
- Phone: 310-467-8353
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SAEED
ESHRAGHI
Title or Position: MD/ CEO
Credential: MD
Phone: 310-467-8353