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NPI Code Detail

MEDICARE: AMIR HEDAYATI M.D.

MEDICARE: AMIR HEDAYATI M.D.
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
12085R0202XDiagnostic Radiology Physician036148014IL
22085R0202XDiagnostic Radiology PhysicianA94491CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770534869
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIR HEDAYATI M.D.
Provider Business Mailing Address
First Line : 2801 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806
Country : US
Telephone Number : 562-933-1550
Fax Number : 562-933-8088
Provider Business Practice Location Address
First Line : 1401 W SEMINOLE BLVD
Second Line :
City : SANFORD
State : FL
Zip : 32771-6737
Country : US
Telephone Number : 516-445-8409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 02/26/2026

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