Healthcare Provider Details

I. General information

NPI: 1205023512
Provider Name (Legal Business Name): ROOZBEH BADII M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 CHARMANT DR APT 423
SAN DIEGO CA
92122-4388
US

IV. Provider business mailing address

7225 CHARMANT DR APT 423
SAN DIEGO CA
92122-4388
US

V. Phone/Fax

Practice location:
  • Phone: 860-538-8938
  • Fax:
Mailing address:
  • Phone: 860-538-8938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number045831
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number238380
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number045831
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: