Healthcare Provider Details

I. General information

NPI: 1790868909
Provider Name (Legal Business Name): BIJAN HAGHIGHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W LA VETA AVE STE 104
ORANGE CA
92868-3928
US

IV. Provider business mailing address

805 W LA VETA AVE STE 104
ORANGE CA
92868-3928
US

V. Phone/Fax

Practice location:
  • Phone: 714-288-4044
  • Fax: 714-288-4042
Mailing address:
  • Phone: 714-288-4044
  • Fax: 714-288-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG81258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: