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General NPI Number Information
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NPI Number | 1487822326
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Entity Type | Organization
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Legal Business Name | BABAK PEZESHKI, M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 520 SUPERIOR AVE SUITE 280
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3637
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Country | US
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Telephone | 949-645-2800
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Fax | 949-645-2810
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Provider Business Mailing Address
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Address Line | 520 SUPERIOR AVE SUITE 280
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3637
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Country | US
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Telephone | 949-645-2800
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Fax | 949-645-2810
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BABAK PEZESHKI
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Credential | M.D.
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Telephone | 949-645-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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