Provider Demographics
NPI:1326038605
Name:HAMIDI, KAMRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMRAN
Middle Name:
Last Name:HAMIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KAMRAN
Other - Middle Name:
Other - Last Name:HAMIDI ASL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5482 WILSHIRE BLVD # 1535
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4218
Mailing Address - Country:US
Mailing Address - Phone:310-201-2871
Mailing Address - Fax:877-916-9777
Practice Address - Street 1:31852 COAST HWY
Practice Address - Street 2:SUITE 301
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6764
Practice Address - Country:US
Practice Address - Phone:310-201-2871
Practice Address - Fax:877-916-9777
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85217207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01055028AOtherINDIANA MEDICAL LICENSE
CA1992815047OtherSINA INFECTIOUS GROUP NPI
CA1326038605OtherNPI
WA 85217AOtherPERSONAL ID NUMBER
WA 85217AOtherPERSONAL ID NUMBER
I57506Medicare UPIN
IN01055028AOtherINDIANA MEDICAL LICENSE