Provider Demographics
NPI:1609022938
Name:HALATI, ALIREZA (MD)
Entity Type:Individual
Prefix:
First Name:ALIREZA
Middle Name:
Last Name:HALATI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:478 S ANAHEIM HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4760
Mailing Address - Country:US
Mailing Address - Phone:714-282-5437
Mailing Address - Fax:714-282-8724
Practice Address - Street 1:478 SOUTH ANAHEIM HILLS ROAD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807
Practice Address - Country:US
Practice Address - Phone:714-282-5437
Practice Address - Fax:714-282-8724
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2021-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA92433208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics