Provider Demographics
NPI:1760580716
Name:HAMI, ANOOSHIRAVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANOOSHIRAVAN
Middle Name:
Last Name:HAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 W BALL RD STE 207
Mailing Address - Street 2:
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 RD STE 207
Practice Address - Street 2:
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
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67031207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G670310Medicaid
CA290010194OtherMEDICARE RR
CA290010194OtherMEDICARE RR
BH2261725OtherDEA NUMBER
CAWG67031EMedicare PIN
CAWG67031DMedicare PIN