Provider Demographics
NPI:1437739133
Name:BAHBAK ADRANGI MD
Entity Type:Organization
Organization Name:BAHBAK ADRANGI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTH OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BAHBAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADRANGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-401-4137
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47308-0568
Mailing Address - Country:US
Mailing Address - Phone:765-284-0493
Mailing Address - Fax:
Practice Address - Street 1:1415 ROSS AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4306
Practice Address - Country:US
Practice Address - Phone:765-284-0493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty