MEDICARE: MORADI MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	A92450	CA

General Provider Information

NPI Number	:	1245560143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORADI MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	210 N TUSTIN AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3807
Country	:	US
Telephone Number	:	800-883-7243
Fax Number	:	714-647-1245

Provider Business Practice Location Address
First Line	:	7305 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5736
Country	:	US
Telephone Number	:	323-584-8222
Fax Number	:	323-584-8606

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NASSIM MORADI
Credential	:	M.D.
Telephone Number	:	800-883-7243

Provider Enumeration Date	:	12/28/2009
Last Update Date	:	03/01/2010

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