Provider Demographics
NPI:1295960995
Name:ELHAM JAFARIMOJARRAD M.D., INC.
Entity type:Organization
Organization Name:ELHAM JAFARIMOJARRAD M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFARIMOJARRAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-793-3376
Mailing Address - Street 1:PO BOX 7894
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-7894
Mailing Address - Country:US
Mailing Address - Phone:949-793-3376
Mailing Address - Fax:949-335-9809
Practice Address - Street 1:18 ENDEAVOR
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3164
Practice Address - Country:US
Practice Address - Phone:949-793-3376
Practice Address - Fax:949-335-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA971602084N0008X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1356501084OtherNPI (INDIVIDUAL)