Doctor Name: | DR. SIAMAK AGHA MOHAMMADI |
NPI Number: | 1871675033 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD426291 |
Business Practice Address: | 2121 E Coast Hwy Ste 260 Corona Del Mar, CA - 926251932 |
Business Phone Number: | 9496442442 |
Business Fax Number: | 9496442518 |
Mailing Address: | 2121 E Coast Hwy Ste 260, CORONA DEL MAR |
State: | CA |
Postal Code: | 926251932 |
Phone Number: | 9496442442 |
Fax Number: | 9496442518 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 05/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD426291 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |