Provider Demographics
NPI:1619920816
Name:MOVAHHEDIAN, HAMID R (MD)
Entity type:Individual
Prefix:
First Name:HAMID
Middle Name:R
Last Name:MOVAHHEDIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4002 VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4506
Mailing Address - Country:US
Mailing Address - Phone:760-940-3386
Mailing Address - Fax:
Practice Address - Street 1:TRI CITY MEDICAL CENTER
Practice Address - Street 2:4002 VISTA WAY
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056
Practice Address - Country:US
Practice Address - Phone:760-940-3386
Practice Address - Fax:760-940-7770
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA492532086S0120X, 208M00000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist