Provider Demographics
NPI:1780050054
Name:HARBOR PSYCHIATRY & MENTAL HEALTH, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:HARBOR PSYCHIATRY & MENTAL HEALTH, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GISOO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARRABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-338-7158
Mailing Address - Street 1:4631 TELLER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-8105
Mailing Address - Country:US
Mailing Address - Phone:949-887-7187
Mailing Address - Fax:949-476-3080
Practice Address - Street 1:4631 TELLER AVE STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8105
Practice Address - Country:US
Practice Address - Phone:949-887-7187
Practice Address - Fax:949-476-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1179902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB217492Medicare PIN