| Ardalan Babaknia M D Professional Corporation | |
|
15775 Laguna Canyon Rd Suite 240 Irvine CA 92618-3189 | |
| (949) 753-8844 | |
| (949) 753-0181 |
| Full Name | Ardalan Babaknia M D Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 15775 Laguna Canyon Rd, Irvine, California |
| Authorized Official Name and Position | Ardalan Babaknia (OWNER) |
| Authorized Official Contact | 9497538844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ardalan Babaknia M D Professional Corporation 15775 Laguna Canyon Rd Suite 240 Irvine CA 92618-3189 Ph: (949) 753-8844 | Ardalan Babaknia M D Professional Corporation 15775 Laguna Canyon Rd Suite 240 Irvine CA 92618-3189 Ph: (949) 753-8844 |
| NPI Number | 1134452725 |
|---|---|
| Provider Enumeration Date | 09/14/2009 |
| Last Update Date | 11/23/2022 |
| Medicare PECOS PAC ID | 3870649668 |
|---|---|
| Medicare Enrollment ID | O20090921000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134452725 | NPI | - | NPPES |
| 00036607 | Other | CA | CITY BUSINESS LICENSE |
| A44193 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Ardalan Babaknia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366527491 PECOS PAC ID: 2062478936 Enrollment ID: I20090921000085 |
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