Provider Demographics
NPI:1457373342
Name:FORGHANI-ARANI, MEHRDAD (DO)
Entity Type:Individual
Prefix:DR
First Name:MEHRDAD
Middle Name:
Last Name:FORGHANI-ARANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17801 LUCERO WAY
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2660
Mailing Address - Country:US
Mailing Address - Phone:714-537-1387
Mailing Address - Fax:714-537-0917
Practice Address - Street 1:12665 GARDEN GROVE BLVD STE 601
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1920
Practice Address - Country:US
Practice Address - Phone:714-537-1387
Practice Address - Fax:714-537-0917
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8699207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX86991Medicaid
CA1912176264Medicaid
CAW17279OtherGROUP MEDICARE ID NUMBER
ILH56008Medicare UPIN
CA00AX86991Medicaid
CAY09998Medicare UPIN