Healthcare Provider Details

I. General information

NPI: 1063647865
Provider Name (Legal Business Name): PEJMAN BADIEI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2009
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOAG DR
NEWPORT BEACH CA
92663-4162
US

IV. Provider business mailing address

361 HOSPITAL RD STE 521
NEWPORT BEACH CA
92663-3526
US

V. Phone/Fax

Practice location:
  • Phone: 949-873-6181
  • Fax:
Mailing address:
  • Phone: 949-873-6181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA121014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: