Provider Demographics
NPI:1225071418
Name:BAHRANI, ANN AWATIF (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:AWATIF
Last Name:BAHRANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:AWATIF
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:44 RIDGE LINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-640-5936
Mailing Address - Fax:
Practice Address - Street 1:16152 BEACH BLVD
Practice Address - Street 2:STE 200
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647
Practice Address - Country:US
Practice Address - Phone:714-841-6772
Practice Address - Fax:714-841-6775
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC421012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry