Organization Active NPI

FM Medical Professional Corporation

  • Family Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1841696283
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FM MEDICAL PROFESSIONAL CORPORATION
Practice address
1400 Quail St
Suite 150
Newport Beach, CA 92660-2730
Phone
(949) 306-1663
NPI assigned
Nov 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Authorized official

Name
Farzin Mohtadi, DO
Title
President
Phone
(949) 306-1663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1400 Quail St
Suite 150
Newport Beach, CA 92660-2730

Mailing address

25108 Marguerite Pkwy
Suite A203
Mission Viejo, CA 92692-2400

National Provider Directory

National Provider Directory

Locations

17911 Sky Park Cir
Ste C
Irvine, CA 92614

25108 Marguerite Pkwy
Ste A203
Mission Viejo, CA 92692

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1841696283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25108 MARGUERITE PKWY",
            "address_2": "SUITE A203",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926922400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 QUAIL ST",
            "address_2": "SUITE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602730",
            "telephone_number": "949-306-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FM MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "MOHTADI",
        "authorized_official_first_name": "FARZIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-306-1663",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.