Provider Demographics
NPI:1003161522
Name:ESTAKHRI, HADI (MD)
Entity Type:Individual
Prefix:DR
First Name:HADI
Middle Name:
Last Name:ESTAKHRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 DOVE ST STE 420
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2420
Mailing Address - Country:US
Mailing Address - Phone:949-945-0927
Mailing Address - Fax:949-269-6263
Practice Address - Street 1:1401 DOVE ST STE 420
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2420
Practice Address - Country:US
Practice Address - Phone:949-945-0927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA836022084P0800X
MI43015002702084P0800X
NY2847362084P0800X
NC2019-019922084P0800X
AZ587242084P0800X
NMMD2019-07692084P0800X
ORMD1932682084P0800X
CA1470682084P0802X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry