Provider Demographics
NPI:1285528794
Name:HEIDI REGENASS MD PC
Entity type:Organization
Organization Name:HEIDI REGENASS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:REGENASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-828-3495
Mailing Address - Street 1:2549 EASTBLUFF DR # 454
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3500
Mailing Address - Country:US
Mailing Address - Phone:602-828-3495
Mailing Address - Fax:
Practice Address - Street 1:1945 E 17TH ST STE 107
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6862
Practice Address - Country:US
Practice Address - Phone:714-500-7714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty