Haideh Mobarak, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A97509 Issued in CA

Practice address

2650 S Bristol St
101&103
Santa Ana, CA 92704-5751

Phone

(714) 754-1444

Fax

(714) 754-7009

NPI assigned

Jan 21, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: haideh.mobarak.p4@direct.scpeds.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Coast Pediatrics

  • Pediatrics Physician
  • Santa Ana, CA
  • NPI 1568495364
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1093991002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CAPOBELLA",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148103",
            "telephone_number": "949-474-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 S BRISTOL ST",
            "address_2": "101&103",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045751",
            "telephone_number": "714-754-1444",
            "fax_number": "714-754-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBARAK",
        "first_name": "HAIDEH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A97509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Mizokawa, MA, CCC-SLP
• Charlotte Maria Primo Mizuta, PMH-NP
• Christine Mary Mlot, M.D.
• Kelly Valerie Moa
• Cherine Moazam, D.O.
• Mobile Medical Examination Services
• Mobile Medical Examination Services Mso
• Mobile Mohs Inc.
• Jazminne Mobley
• Michael Austin Mobley, ASW, PPSC

• Specialist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.