Healthcare Provider Details

I. General information

NPI: 1629212378
Provider Name (Legal Business Name): PARHAM PARTO M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SUPERIOR AVE STE 305
NEWPORT BEACH CA
92663-3667
US

IV. Provider business mailing address

4255 CAMPUS DR UNIT 4658
IRVINE CA
92616-2232
US

V. Phone/Fax

Practice location:
  • Phone: 949-650-0240
  • Fax:
Mailing address:
  • Phone: 310-448-2693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP1-0034940
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.205974
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: