Healthcare Provider Details

I. General information

NPI: 1457829731
Provider Name (Legal Business Name): ALLIED PSYCHIATRY AND MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 07/15/2020
Certification Date: 07/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 DOVE ST STE 420
NEWPORT BEACH CA
92660-2420
US

IV. Provider business mailing address

1401 DOVE ST STE 420
NEWPORT BEACH CA
92660-2420
US

V. Phone/Fax

Practice location:
  • Phone: 949-945-0927
  • Fax: 949-269-6263
Mailing address:
  • Phone: 949-945-0927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HADI ESTAKHRI
Title or Position: PRESIDENT
Credential: MD
Phone: 617-314-4552