Provider Demographics
NPI:1336569862
Name:FEIZABADI, NARGES
Entity Type:Individual
Prefix:
First Name:NARGES
Middle Name:
Last Name:FEIZABADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 SAND CANYON AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3724
Mailing Address - Country:US
Mailing Address - Phone:949-393-7443
Mailing Address - Fax:949-387-2653
Practice Address - Street 1:16100 SAND CANYON AVE STE 240
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3724
Practice Address - Country:US
Practice Address - Phone:949-393-7443
Practice Address - Fax:949-387-2653
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000593363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care