Provider Demographics
NPI:1700150729
Name:VAHID MAHABADI, MD., INC
Entity Type:Organization
Organization Name:VAHID MAHABADI, MD., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHABADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,MPH
Authorized Official - Phone:661-222-2300
Mailing Address - Street 1:24731 GARLAND DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4960
Mailing Address - Country:US
Mailing Address - Phone:661-222-2300
Mailing Address - Fax:844-273-2445
Practice Address - Street 1:24731 GARLAND DRIVE
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4960
Practice Address - Country:US
Practice Address - Phone:661-222-2300
Practice Address - Fax:844-273-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91861207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1144412453OtherCA-LICENSE A91861