Provider Demographics
NPI:1205023512
Name:BADII, ROOZBEH (MD)
Entity Type:Individual
Prefix:
First Name:ROOZBEH
Middle Name:
Last Name:BADII
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 1:7225 CHARMANT DR
Mailing Address - Street 2:APT 423
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-4388
Mailing Address - Country:US
Mailing Address - Phone:860-538-8938
Mailing Address - Fax:
Practice Address - Street 1:7225 CHARMANT DR
Practice Address - Street 2:APT 423
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-4388
Practice Address - Country:US
Practice Address - Phone:860-538-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045831208M00000X, 207R00000X
MA238380207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT045831OtherCT LICENSE