Active NPI
Azita Mavandadi, PHARMD
- Clinical Pharmacology Physician
- Huntington Beach, CA
National Provider Identifier
1215934468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pharmacology Physician
- License
- 49724
- Practice address
- 19066 Magnolia St
Huntington Beach, CA 92646-2232 - Phone
- (714) 968-0068
- Fax
- (714) 378-2188
- NPI assigned
- Jul 1, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pharmacology Physician | 208U00000X | 49724 | CA | Primary |
Addresses
Primary practice location
19066 Magnolia St
Huntington Beach, CA 92646-2232
Mailing address
4607 Fairfield Dr
Corona del Mar, CA 92625-3110
Phone (949) 640-6330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0497240 | Other | CA | MEDI CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49724 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1215934468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4607 FAIRFIELD DR",
"city": "CORONA DEL MAR",
"state": "CA",
"postal_code": "926253110",
"telephone_number": "949-640-6330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19066 MAGNOLIA ST",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926462232",
"telephone_number": "714-968-0068",
"fax_number": "714-378-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAVANDADI",
"first_name": "AZITA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-01",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208U00000X",
"taxonomy_group": "",
"desc": "Clinical Pharmacology",
"state": "CA",
"license": "49724",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI CAL",
"identifier": "0497240",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.