Provider Demographics
NPI:1578566998
Name:JHANGIANI, HARESH S (MD)
Entity Type:Individual
Prefix:
First Name:HARESH
Middle Name:S
Last Name:JHANGIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11180 WARNER AVE
Mailing Address - Street 2:STE 351
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7516
Mailing Address - Country:US
Mailing Address - Phone:714-698-0300
Mailing Address - Fax:714-698-0302
Practice Address - Street 1:11180 WARNER AVE
Practice Address - Street 2:STE 351
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7516
Practice Address - Country:US
Practice Address - Phone:714-698-0300
Practice Address - Fax:714-698-0302
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38872174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A388720Medicaid
CAWA38872GMedicare PIN
CAE10562Medicare UPIN