Provider Demographics
NPI:1801922448
Name:DEIRDRE A. HABERMEHL, M.D., INC.
Entity type:Organization
Organization Name:DEIRDRE A. HABERMEHL, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEIRDRE
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:HABERMEHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-548-6376
Mailing Address - Street 1:18800 MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1718
Mailing Address - Country:US
Mailing Address - Phone:949-548-6376
Mailing Address - Fax:866-677-2855
Practice Address - Street 1:18800 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1718
Practice Address - Country:US
Practice Address - Phone:949-548-6376
Practice Address - Fax:866-677-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61-1153207RA0401X
CAG060299207V00000X
CAG60299207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty