Provider Demographics
NPI:1417000563
Name:MOROVATI, ABDI (DO)
Entity Type:Individual
Prefix:
First Name:ABDI
Middle Name:
Last Name:MOROVATI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 W 5TH AVE
Mailing Address - Street 2:STE 1000
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2975
Mailing Address - Country:US
Mailing Address - Phone:509-838-2531
Mailing Address - Fax:
Practice Address - Street 1:150 N ROBERTSON BLVD STE 205
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2144
Practice Address - Country:US
Practice Address - Phone:310-657-8585
Practice Address - Fax:310-657-8484
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A66322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX66320Medicaid
CAG91608Medicare UPIN