Babak Roshdieh, M.D. Corp.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A76333 Issued in CA

Legal business name

BABAK ROSHDIEH, M.D. CORP.

Practice address

770 Magnolia Ave
Suite 2G
Corona, CA 92879-3120

Phone

(951) 734-6500

Fax

(951) 734-6555

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Babak Roshdieh, M.D.

Title

Owner

Phone

(951) 734-6500

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1992751440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MAGNOLIA AVE",
            "address_2": "SUITE 2G",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793120",
            "telephone_number": "951-734-6500",
            "fax_number": "951-734-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MAGNOLIA AVE",
            "address_2": "SUITE 2G",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793120",
            "telephone_number": "951-734-6500",
            "fax_number": "951-734-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BABAK ROSHDIEH, M.D. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "ROSHDIEH",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-734-6500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A76333",
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Corona, CA
• Providers in Corona, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.