Provider Demographics
NPI:1831989458
Name:DBA BARRANCA LABORATORY
Entity type:Organization
Organization Name:DBA BARRANCA LABORATORY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAED
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAT SADEGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-962-9523
Mailing Address - Street 1:219 ISABELLA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-0312
Mailing Address - Country:US
Mailing Address - Phone:310-962-9523
Mailing Address - Fax:
Practice Address - Street 1:3972M BARRANCA PKWY UNIT M
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8238
Practice Address - Country:US
Practice Address - Phone:310-962-9523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST DIAGNOSTICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory