Provider Demographics
NPI:1952896557
Name:PARHAM PARTO M D INC
Entity Type:Organization
Organization Name:PARHAM PARTO M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PARHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-650-2400
Mailing Address - Street 1:4255 CAMPUS DR UNIT 4658
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92616-2232
Mailing Address - Country:US
Mailing Address - Phone:949-650-2400
Mailing Address - Fax:
Practice Address - Street 1:520 SUPERIOR AVE STE 305
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3667
Practice Address - Country:US
Practice Address - Phone:949-650-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118697174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA118697OtherCARDIOLOGY
CAA118697OtherINTERVENTIONAL CARDIOLOGY