Basic Information
| Provider Information | |||||||||
| NPI: | 1265726707 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH COUNTY NEONATOLOGY SPECIALISTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4536 | ||||||||
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| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920524536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609403386 | ||||||||
| FaxNumber: | 7609407770 | ||||||||
| Practice Location | |||||||||
| Address1: | 4002 VISTA WAY | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920564506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609403386 | ||||||||
| FaxNumber: | 7609407770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2011 | ||||||||
| LastUpdateDate: | 06/10/2014 | ||||||||
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| AuthorizedOfficialLastName: | MOVAHHEDIAN | ||||||||
| AuthorizedOfficialFirstName: | HAMID | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7609403386 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0202X | A49253 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 2080N0001X | A49253 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.