Provider Demographics
NPI:1265726707
Name:NORTH COUNTY NEONATOLOGY SPECIALISTS
Entity type:Organization
Organization Name:NORTH COUNTY NEONATOLOGY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOVAHHEDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-940-3386
Mailing Address - Street 1:PO BOX 4536
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92052-4536
Mailing Address - Country:US
Mailing Address - Phone:760-940-3386
Mailing Address - Fax:760-940-7770
Practice Address - Street 1:4002 VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4506
Practice Address - Country:US
Practice Address - Phone:760-940-3386
Practice Address - Fax:760-940-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA492532080P0202X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty