Provider Demographics
NPI:1164655817
Name:ABADIAN SHARIFABAD, MANOOCHEHR (MD)
Entity Type:Individual
Prefix:DR
First Name:MANOOCHEHR
Middle Name:
Last Name:ABADIAN SHARIFABAD
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 1:17100 EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4004
Mailing Address - Country:US
Mailing Address - Phone:714-241-8552
Mailing Address - Fax:714-241-8551
Practice Address - Street 1:17100 EUCLID ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4004
Practice Address - Country:US
Practice Address - Phone:714-241-8552
Practice Address - Fax:714-241-8551
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301099978207RP1001X
CAA107180207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease