Provider Demographics
NPI:1538378765
Name:SARABI, DENNIS (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:SARABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAHZYAR
Other - Middle Name:DENNIS
Other - Last Name:MOHAMMADZADEH SARABI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-0155
Mailing Address - Country:US
Mailing Address - Phone:949-706-1114
Mailing Address - Fax:949-706-8490
Practice Address - Street 1:400 NEWPORT CENTER DR STE 610
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7623
Practice Address - Country:US
Practice Address - Phone:949-706-1114
Practice Address - Fax:949-706-3286
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106259207RC0000X, 207RC0000X
PAMD430527207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232664784OtherTIN
CABL258ZMedicare PIN