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General NPI Number Information
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NPI Number | 1548640311
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Entity Type | Organization
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Legal Business Name | NOROOZ CLINIC FOUNDATION
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 1560 BROOKHOLLOW DR STE 212
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City | SANTA ANA
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State | CA
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Zip | 92705-5411
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Country | US
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Telephone | 949-242-7920
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 BROOKHOLLOW DR STE 212
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City | SANTA ANA
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State | CA
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Zip | 92705-5411
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Country | US
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Telephone | 949-242-7920
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EHSAN GHARADJEDAGHI
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Credential | PSYD
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Telephone | 949-310-2993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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