Provider Demographics
NPI:1639447956
Name:ABES S. BAGHERI, M.D., INC.
Entity Type:Organization
Organization Name:ABES S. BAGHERI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABES
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAGHERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-431-1918
Mailing Address - Street 1:3801 KATELLA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3338
Mailing Address - Country:US
Mailing Address - Phone:562-431-1918
Mailing Address - Fax:562-431-2423
Practice Address - Street 1:3801 KATELLA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3338
Practice Address - Country:US
Practice Address - Phone:562-431-1918
Practice Address - Fax:562-431-2423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA308892084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty