Provider Demographics
NPI:1770664377
Name:DARRODI, HORYEH SHAHLA (OMD)
Entity Type:Individual
Prefix:DR
First Name:HORYEH
Middle Name:SHAHLA
Last Name:DARRODI
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:HORYEH
Other - Middle Name:DARRODI
Other - Last Name:SHAHBAZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23412 MOULTON PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1732
Mailing Address - Country:US
Mailing Address - Phone:949-829-6927
Mailing Address - Fax:949-829-0221
Practice Address - Street 1:144 E YALE LOOP
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-3708
Practice Address - Country:US
Practice Address - Phone:949-378-0348
Practice Address - Fax:949-829-0221
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7708171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist