Hamid Fadavi DO Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A11189 Issued in CA

Legal business name

HAMID FADAVI DO INC

Practice address

26932 Oso Pkwy
Suite 275
Mission Viejo, CA 92691-5815

Phone

(949) 916-8100

Fax

(949) 916-8555

NPI assigned

Mar 20, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Hamid Fadavi, D.ONPI 1477787034

Title

Persident

Phone

(949) 916-8100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hamid R Fadavi, D.O.

  • Interventional Pain Medicine Physician
  • Mission Viejo, CA
  • NPI 1477787034
  Medicare reassignment Authorized official
• Bradford Lively, PA-C

  • Physician Assistant
  • Laguna Hills, CA
  • NPI 1134846835
  Medicare reassignment NPD
• Lindsay Brown, PA-C

  • Physician Assistant
  • Westminster, CA
  • NPI 1396546164
  Medicare reassignment

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1811239536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26932 OSO PKWY",
            "address_2": "SUITE 275",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915815",
            "telephone_number": "949-916-8100",
            "fax_number": "949-916-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26932 OSO PKWY",
            "address_2": "SUITE 275",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915815",
            "telephone_number": "949-916-8100",
            "fax_number": "949-916-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMID FADAVI DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "FADAVI",
        "authorized_official_first_name": "HAMID",
        "authorized_official_title_or_position": "PERSIDENT",
        "authorized_official_telephone_number": "949-916-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A11189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "HF034A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis P Haghighat, M.D.
• Amy E Haines, AU.D.
• Tatiana Kathleen Hajou, FNP-BC
• Rashelle Rentya Hakak, M.A
• Johannah Gail Hale, NP
• Hamid R Salehi MD a Professional Medical Corporation
• Denise Hamilton, MD
• Tate Noell Hamilton
• Jessica Elizabeth Hammond, LPCC
• Estera Han, MSN, FNP

• Physical Medicine & Rehabilitation Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.