Provider Demographics
NPI:1568449171
Name:HAGHIGHAT, DENNIS P (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:P
Last Name:HAGHIGHAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27451 LOS ALTOS
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6331
Mailing Address - Country:US
Mailing Address - Phone:949-282-1600
Mailing Address - Fax:949-367-0518
Practice Address - Street 1:26800 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6306
Practice Address - Country:US
Practice Address - Phone:949-364-6000
Practice Address - Fax:949-364-3430
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG61750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G617500Medicaid
CAWG61750GMedicare PIN
CAE10578Medicare UPIN