1912660549 NPI number — DR HAMIDI EXCELLENT CARE A PROFESSIONAL CORPORATION

Table of content: DR. QUANG DUY VO PHARMD (NPI 1972684041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912660549 NPI number — DR HAMIDI EXCELLENT CARE A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR HAMIDI EXCELLENT CARE A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912660549
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30511 AVENIDA DE LAS FLORES # 1064
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANCHO SANTA MARGARITA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92688-3941
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-933-5050
Provider Business Mailing Address Fax Number:
941-833-7581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24451 HEALTH CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAGUNA HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92653-3689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-933-5050
Provider Business Practice Location Address Fax Number:
941-833-7581
Provider Enumeration Date:
10/20/2021

Additional Information

Authorized Official

Authorized Official Last Name:
HAMIDI
Authorized Official First Name:
AFSHIN
Authorized Official Middle Name:
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
858-933-5050

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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