Provider Demographics
NPI:1083395826
Name:DR ALEXANDER GHOBADIMANESH PC
Entity Type:Organization
Organization Name:DR ALEXANDER GHOBADIMANESH PC
Other - Org Name:MIND BODY FOCUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOBADIMANESH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-323-8475
Mailing Address - Street 1:27201 PUERTA REAL STE 300
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8590
Mailing Address - Country:US
Mailing Address - Phone:949-323-8475
Mailing Address - Fax:877-611-5894
Practice Address - Street 1:27201 PUERTA REAL STE 300
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8590
Practice Address - Country:US
Practice Address - Phone:949-323-8475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty