Provider Demographics
NPI:1225501133
Name:MOKABBERI MD INC
Entity Type:Organization
Organization Name:MOKABBERI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RASOUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOKABBERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-436-3773
Mailing Address - Street 1:1200 N TUSTIN AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3534
Mailing Address - Country:US
Mailing Address - Phone:714-543-9855
Mailing Address - Fax:
Practice Address - Street 1:1200 N TUSTIN AVE STE 260
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3534
Practice Address - Country:US
Practice Address - Phone:714-543-9855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty