Provider Demographics
NPI:1013904424
Name:HABIBIPOUR, SAIED (MD)
Entity Type:Individual
Prefix:
First Name:SAIED
Middle Name:
Last Name:HABIBIPOUR
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 1:3973 VISTA VERDE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-1231
Mailing Address - Country:US
Mailing Address - Phone:760-416-1376
Mailing Address - Fax:760-416-1381
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:E318
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-1376
Practice Address - Fax:760-416-1381
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80162208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A801620Medicaid
CA00A801620Medicare ID - Type Unspecified
CAH28148Medicare UPIN