Provider Demographics
NPI:1972666840
Name:HAMID MIR MD INC
Entity Type:Organization
Organization Name:HAMID MIR MD INC
Other - Org Name:HAMID MIRALIAKBAR MD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:R
Authorized Official - Last Name:MIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-988-7848
Mailing Address - Street 1:220 NEWPORT CENTER DR # 11-282
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7506
Mailing Address - Country:US
Mailing Address - Phone:949-988-7848
Mailing Address - Fax:949-988-7801
Practice Address - Street 1:3501 JAMBOREE RD
Practice Address - Street 2:SUITE 1250
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2939
Practice Address - Country:US
Practice Address - Phone:949-988-7848
Practice Address - Fax:949-988-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84242207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17929Medicare ID - Type Unspecified
CAY16512Medicare UPIN
WA84242BMedicare ID - Type Unspecified