Basic Information
| Provider Information | |||||||||
| NPI: | 1811427875 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BAVAND II PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1555 PALM BEACH LAKES BLVD STE 600 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334012333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619659110 | ||||||||
| FaxNumber: | 5616847754 | ||||||||
| Practice Location | |||||||||
| Address1: | 18632 BEACH BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926482047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149623633 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2017 | ||||||||
| LastUpdateDate: | 01/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | YOUSSEFZADEH | ||||||||
| AuthorizedOfficialFirstName: | BAVAND | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 8584556800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.