Healthcare Provider Details

I. General information

NPI: 1902001407
Provider Name (Legal Business Name): NAVID NAVIZADEH MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23823 VALENCIA BLVD 140
VALENCIA CA
91355-9513
US

IV. Provider business mailing address

23823 VALENCIA BLVD 140
VALENCIA CA
91355-9513
US

V. Phone/Fax

Practice location:
  • Phone: 661-290-3337
  • Fax: 661-253-7356
Mailing address:
  • Phone: 661-290-3337
  • Fax: 661-253-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA078087
License Number StateCA

VIII. Authorized Official

Name: NAVID NAVIZADEH
Title or Position: OWNER
Credential: MD
Phone: 661-290-3337