Provider Demographics
NPI:1912203308
Name:BABAK FIROOZI MD INC
Entity Type:Organization
Organization Name:BABAK FIROOZI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:FIROOZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-662-0770
Mailing Address - Street 1:11100 WARNER AVE
Mailing Address - Street 2:SUITE 266
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7506
Mailing Address - Country:US
Mailing Address - Phone:714-662-0770
Mailing Address - Fax:714-662-2122
Practice Address - Street 1:11100 WARNER AVE
Practice Address - Street 2:SUITE 266
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7506
Practice Address - Country:US
Practice Address - Phone:714-662-0770
Practice Address - Fax:714-662-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC54247207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty