Provider Demographics
NPI:1003028556
Name:HEIDARI, NEDA (MD)
Entity Type:Individual
Prefix:DR
First Name:NEDA
Middle Name:
Last Name:HEIDARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 SOLAR DR STE 165
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-8228
Mailing Address - Country:US
Mailing Address - Phone:805-861-4356
Mailing Address - Fax:
Practice Address - Street 1:1801 SOLAR DR STE 165
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-8228
Practice Address - Country:US
Practice Address - Phone:805-744-2141
Practice Address - Fax:805-744-2151
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102340207T00000X, 2084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery