Provider Demographics
NPI:1710382189
Name:ANOOSHIRAVAN HAMI, M.D., CORP
Entity Type:Organization
Organization Name:ANOOSHIRAVAN HAMI, M.D., CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANOOSHIRAVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-826-7440
Mailing Address - Street 1:3400 W. BALL ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3737
Mailing Address - Country:US
Mailing Address - Phone:714-826-7440
Mailing Address - Fax:714-826-4623
Practice Address - Street 1:3400 W. BALL ROAD
Practice Address - Street 2:SUITE 207
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3737
Practice Address - Country:US
Practice Address - Phone:714-826-7440
Practice Address - Fax:714-826-4623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG067301207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty