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General NPI Number Information
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NPI Number | 1578212874
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Entity Type | Organization
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Legal Business Name | NEDA HEIDARI M.D. INC
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 1801 SOLAR DR STE 165
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City | OXNARD
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State | CA
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Zip | 93030-8228
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Country | US
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Telephone | 805-744-2141
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Fax | 805-744-2151
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Provider Business Mailing Address
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Address Line | 2390 LAS POSAS RD
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City | CAMARILLO
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State | CA
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Zip | 93010-3479
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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 | CEO
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Name | NEDA HEIDARI
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Credential | MD
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Telephone | 805-744-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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