Provider Demographics
NPI:1932527405
Name:ROOBA WARDEH MD INC
Entity Type:Organization
Organization Name:ROOBA WARDEH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROOBA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARDEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-972-2705
Mailing Address - Street 1:2700 N MAIN ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6634
Mailing Address - Country:US
Mailing Address - Phone:714-972-2702
Mailing Address - Fax:
Practice Address - Street 1:2700 N MAIN ST
Practice Address - Street 2:SUITE 506
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6634
Practice Address - Country:US
Practice Address - Phone:714-972-2702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center