Provider Demographics
NPI:1548561665
Name:ETEMADIPOUR, NAVEED
Entity Type:Individual
Prefix:
First Name:NAVEED
Middle Name:
Last Name:ETEMADIPOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 GRAND AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2370
Mailing Address - Country:US
Mailing Address - Phone:760-729-2830
Mailing Address - Fax:760-729-2798
Practice Address - Street 1:785 GRAND AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2370
Practice Address - Country:US
Practice Address - Phone:760-729-2830
Practice Address - Fax:760-729-2798
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)