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General NPI Number Information
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NPI Number | 1043100217
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Entity Type | Organization
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Legal Business Name | KHASHAYAR NATTAGH MD PC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 19712 MACARTHUR BLVD STE 110
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City | IRVINE
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State | CA
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Zip | 92612-2407
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Country | US
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Telephone | 949-242-9172
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Fax |
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Provider Business Mailing Address
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Address Line | 2549 EASTBLUFF DR # 150
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KHASHAYAR NATTAGH
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Credential | MD
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Telephone | 949-242-9172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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