REZA DEHDARI MD INC (NPI# 1083103006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083103006 |
| Entity Type | Organization |
| Organization Name | REZA DEHDARI MD INC |
| Other Organization Name | ADVANCED HEALING INSTITUTE |
| Practice Address |
22972 El Toro Rd Lake Forest CA 92630-4961 |
| Practice Telephone | 9492393206 |
| Mailing Telephone | 9492393206 |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-05-04 |
| Authorized Official Name | REZA DEHDARI (PRESIDENT) |
| Authorized Official Telephone | 9492393206 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Healing Institute | Doing Business As Name - Organization |
| Street Address |
22972 EL TORO RD |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-4961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235225806 | Jeffrey A Paulsen | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2006-10-04 |
| 1356833743 | Mohsen Khamessipour | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2018-06-01 |
| 1679090559 | Dr. Brett Long, Longevity Chiropractic, Inc | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2017-08-23 |
| 1750837605 | Brett D Long | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2016-08-31 |
| 1093908253 | Jeffrey A. Paulsen, Chiropractic Corp. | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2007-08-21 |
| 1619193992 | Mark A Hamilton | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2007-04-17 |
| 1750477337 | Roberto Claudio Pacelli | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2006-10-04 |
| 1710073317 | Jeffrey A. Van Rensselaer | Chiropractor | 22972 El Toro Rd, Lake Forest, CA 92630-4961 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548457955 | Roee Lazebnik | Radiology | 275 N Field Dr, Lake Forest, IL 60045-2579 | 2007-09-29 |
| 1194741389 | Dana A Gray | Radiology | 660 N Westmoreland Rd Dept Of, Lake Forest, IL 60045-1659 | 2006-07-14 |
| 1194724542 | Unique Medical Imaging Sc | Radiology | 840 S Waukegan Rd, Suite 214, Lake Forest, IL 60045-2608 | 2005-07-19 |
| 1972846236 | Lioubov Soulii | Radiology | 1000 N Westmoreland Rd, Lake Forest, IL 60045-1658 | 2013-04-04 |
| 1184987356 | Saudur Rahman | Radiology | 1000 N Westmoreland Rd, Lake Forest, IL 60045-1658 | 2012-06-21 |
| 1063778462 | Ramanujam Govindarajan Prativadi | Radiology | 1000 N Westmoreland Rd, Radiology Department, Lake Forest, IL 60045-1658 | 2012-04-10 |
| 1205102019 | Firas Ramahi | Radiology | 1000 N Westmoreland Rd, Lake Forest, IL 60045 | 2012-03-26 |
| 1215101712 | Steven C Sauk | Radiology | 1000 N Westmoreland Rd, Lake Forest, IL 60045 | 2008-04-15 |
| 1467656041 | Deepa Nonesupplied Popuri | Radiology | 1000 N Westmoreland Rd, Lake Forest, IL 60045-1658 | 2007-06-14 |
| 1407893795 | Kirby P Clark | Radiology | 660 N Westmoreland Rd, Lake Forest, IL 60045-1659 | 2006-06-02 |
| Find all providers in LAKE FOREST | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
Please comment or provide details below to improve the information on REZA DEHDARI MD INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.