Provider Demographics
NPI:1467647909
Name:OUTPATIENT HEALTHCARE INC.
Entity Type:Organization
Organization Name:OUTPATIENT HEALTHCARE INC.
Other - Org Name:EASTBLUFF MEDICAL WALK-IN & URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSOUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-269-8416
Mailing Address - Street 1:2507 EASTBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3504
Mailing Address - Country:US
Mailing Address - Phone:949-200-1655
Mailing Address - Fax:949-200-1650
Practice Address - Street 1:2507 EASTBLUFF DR.
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-200-1655
Practice Address - Fax:949-200-1650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
W22192Medicare UPIN