Provider Demographics
NPI:1043078918
Name:IRIS PARTOVI MD INC
Entity Type:Organization
Organization Name:IRIS PARTOVI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTOVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-486-1368
Mailing Address - Street 1:27743 HIDDEN TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7821
Mailing Address - Country:US
Mailing Address - Phone:877-486-1368
Mailing Address - Fax:
Practice Address - Street 1:44811 DATE AVE STE D
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3136
Practice Address - Country:US
Practice Address - Phone:877-486-1368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty