Provider Demographics
NPI:1396877213
Name:BAHRAM ALAVYNEJAD, MD, INC.
Entity type:Organization
Organization Name:BAHRAM ALAVYNEJAD, MD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAVYNEJAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-255-8000
Mailing Address - Street 1:235 E IMPERIAL HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4982
Mailing Address - Country:US
Mailing Address - Phone:714-255-8000
Mailing Address - Fax:714-255-1586
Practice Address - Street 1:235 E IMPERIAL HWY
Practice Address - Street 2:SUITE B
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4982
Practice Address - Country:US
Practice Address - Phone:714-255-8000
Practice Address - Fax:714-255-1586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA202146207R00000X, 207RP1001X
CA2998207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Not Answered207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty