| Michael B. Mortazie, D.o. Inc. | |
|
1506 E Chapman Ave Orange CA 92866-2231 | |
| (714) 538-8556 | |
| (714) 538-1082 |
| Full Name | Michael B. Mortazie, D.o. Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1506 E Chapman Ave, Orange, California |
| Authorized Official Name and Position | Michael Babak Mortazie (PRESIDENT) |
| Authorized Official Contact | 7145388556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael B. Mortazie, D.o. Inc. 1506 E Chapman Ave Orange CA 92866-2231 Ph: (714) 538-8556 | Michael B. Mortazie, D.o. Inc. 1506 E Chapman Ave Orange CA 92866-2231 Ph: (714) 538-8556 |
| NPI Number | 1316572183 |
|---|---|
| Provider Enumeration Date | 03/11/2020 |
| Last Update Date | 03/11/2020 |
| Medicare PECOS PAC ID | 4082045232 |
|---|---|
| Medicare Enrollment ID | O20200504001499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316572183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Michael B Mortazie |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1457616914 PECOS PAC ID: 7911277298 Enrollment ID: I20170719001279 |
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