Provider Demographics
NPI:1548640311
Name:NOROOZ CLINIC FOUNDATION
Entity type:Organization
Organization Name:NOROOZ CLINIC FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARADJEDAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-310-2993
Mailing Address - Street 1:1560 BROOKHOLLOW DR STE 212
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5411
Mailing Address - Country:US
Mailing Address - Phone:949-242-7920
Mailing Address - Fax:
Practice Address - Street 1:1560 BROOKHOLLOW DR STE 212
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5411
Practice Address - Country:US
Practice Address - Phone:949-242-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health