Provider Demographics
NPI:1881974699
Name:RAVARI, BEHDAD HAMIDI (MD)
Entity type:Individual
Prefix:DR
First Name:BEHDAD
Middle Name:HAMIDI
Last Name:RAVARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15642 SAND CANYON AVE UNIT 54264
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-5445
Mailing Address - Country:US
Mailing Address - Phone:949-836-2529
Mailing Address - Fax:
Practice Address - Street 1:24452 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3604
Practice Address - Country:US
Practice Address - Phone:949-552-5572
Practice Address - Fax:800-756-8714
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA130673208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation