Provider Demographics
NPI:1225067465
Name:HAMOUI, NAHID (MD)
Entity Type:Individual
Prefix:
First Name:NAHID
Middle Name:
Last Name:HAMOUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 604
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-336-8761
Mailing Address - Fax:949-336-8762
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 604
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-336-8761
Practice Address - Fax:949-336-8762
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74889208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A748890Medicaid
CA00A748890OtherBLUE SHIELD PIN
CA00A748890Medicaid
CA00A748890OtherBLUE SHIELD PIN
CAWA74889AMedicare PIN