# ALIREZA HALATI, MD MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750895694
- **Authorized official:** ALIREZA HALATI MD (PRESIDENT)
- **Authorized official phone:** (949) 413-3455

## Contact information

- **Practice address:** 3220 S BREA CANYON RD STE F, DIAMOND BAR, CA 91765-3481
- **Practice address phone:** (909) 598-7868
- **Mailing address:** 3220 S BREA CANYON RD STE F, DIAMOND BAR, CA 91765-3481
- **Mailing address phone:** (909) 598-7868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A92433 | CA | Yes |

## Other

- **Enumeration date:** 11/30/2017
- **Last updated:** 11/30/2017