Provider Demographics
NPI:1497076301
Name:BEHAZIN, NEGIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NEGIN
Middle Name:
Last Name:BEHAZIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 FREEMAN AVE
Mailing Address - Street 2:UNIT 14
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-2406
Mailing Address - Country:US
Mailing Address - Phone:409-234-2946
Mailing Address - Fax:
Practice Address - Street 1:12462 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4759
Practice Address - Country:US
Practice Address - Phone:714-636-9850
Practice Address - Fax:714-636-1248
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131359208D00000X
CAA131359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice