Provider Demographics
NPI:1619920816
Name:MOVAHHEDIAN, HAMID REZA (MD)
Entity Type:Individual
Prefix:
First Name:HAMID
Middle Name:REZA
Last Name:MOVAHHEDIAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1122 MASTERPIECE DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-6803
Mailing Address - Country:US
Mailing Address - Phone:760-630-6428
Mailing Address - Fax:760-630-6428
Practice Address - Street 1:TRI CITY MEDICAL CENTER
Practice Address - Street 2:4002 VISTA WAY
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056
Practice Address - Country:US
Practice Address - Phone:760-940-3386
Practice Address - Fax:760-940-7770
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-04-18
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Provider Licenses
StateLicense IDTaxonomies
CAA492532080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine