Provider Demographics
NPI:1740353283
Name:MIRHASHEMI, SIMA (DO)
Entity type:Individual
Prefix:DR
First Name:SIMA
Middle Name:
Last Name:MIRHASHEMI
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:3334 E COAST HWY
Mailing Address - Street 2:SUITE 522
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2328
Mailing Address - Country:US
Mailing Address - Phone:949-632-5244
Mailing Address - Fax:949-873-2065
Practice Address - Street 1:33 CREEK RD BLDG C2ND
Practice Address - Street 2:SUITE 310
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4791
Practice Address - Country:US
Practice Address - Phone:949-632-5244
Practice Address - Fax:949-873-2065
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2014-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH12425Medicare UPIN