Provider Demographics
NPI:1184813610
Name:H. MEHRDAD SADEGHI M.D., INC.
Entity type:Organization
Organization Name:H. MEHRDAD SADEGHI M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:H.
Authorized Official - Middle Name:MEHRDAD
Authorized Official - Last Name:SADEGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-216-3113
Mailing Address - Street 1:765 MEDICAL CENTER CT
Mailing Address - Street 2:#211
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6600
Mailing Address - Country:US
Mailing Address - Phone:619-216-3113
Mailing Address - Fax:619-216-3204
Practice Address - Street 1:765 MEDICAL CENTER CT
Practice Address - Street 2:#211
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6600
Practice Address - Country:US
Practice Address - Phone:619-216-3113
Practice Address - Fax:619-216-3204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60751207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty