Provider Demographics
NPI:1902175441
Name:BABAIE, CAMELLIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMELLIA
Middle Name:
Last Name:BABAIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23817 GARLAND CT
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-2603
Mailing Address - Country:US
Mailing Address - Phone:562-673-3780
Mailing Address - Fax:661-282-1923
Practice Address - Street 1:23817 GARLAND CT
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354-2603
Practice Address - Country:US
Practice Address - Phone:562-673-3780
Practice Address - Fax:661-282-1923
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119462207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0100430OtherGROUP MEDI-CAL
CAW18762OtherGROUP MEDICARE
CA1902846306OtherGROUP NPI