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General NPI Number Information
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NPI Number | 1700687332
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Entity Type | Organization
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Legal Business Name | BABAK GHAVAMI MD INC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 763 S MAIN ST STE 100
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City | ORANGE
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State | CA
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Zip | 92868-4610
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Country | US
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Telephone | 949-828-1618
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Fax |
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Provider Business Mailing Address
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Address Line | 763 S MAIN ST STE 100
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City | ORANGE
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State | CA
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Zip | 92868-4610
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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 | MEDICAL DOCTOR
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Name | DR. BABAK GHAVAMI
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Credential | MD
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Telephone | 305-510-0737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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