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General NPI Number Information
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NPI Number | 1134758063
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Entity Type | Individual
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Provider Name | MANI VAHIDI MD, MHDS
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Gender | Male
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 4063 BIRCH ST STE 220
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2241
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Country | US
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Telephone | 949-229-5708
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Fax | 334-269-7996
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Provider Business Mailing Address
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Address Line | PO BOX 251751
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City | LOS ANGELES
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State | CA
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Zip | 90025-9133
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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 |
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Name |
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Credential |
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Telephone |
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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 | A191251
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License Number State | CA
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