Provider Demographics
NPI:1588654693
Name:NAVIZADEH, NAVID (MD INC)
Entity Type:Individual
Prefix:
First Name:NAVID
Middle Name:
Last Name:NAVIZADEH
Suffix:
Gender:M
Credentials:MD INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25751 MCBEAN PKWY
Mailing Address - Street 2:220
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3701
Mailing Address - Country:US
Mailing Address - Phone:661-290-3337
Mailing Address - Fax:
Practice Address - Street 1:25751 MCBEAN PKWY
Practice Address - Street 2:220
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3701
Practice Address - Country:US
Practice Address - Phone:661-290-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA078087207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A780870Medicaid
CAWA78087EMedicare PIN
CAW18044Medicare ID - Type Unspecified
CA00A780870Medicaid