Individual
MR. YACOOB VAHED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
447 OLD NEWPORT BLVD STE 200, NEWPORT BEACH, CA 92663-4257
(949) 650-3350
(949) 650-1274
Mailing address
447 OLD NEWPORT BLVD STE 200, NEWPORT BEACH, CA 92663-4257
(949) 650-3350
(949) 650-1274
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA18422
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750339479
NPI - GROUP
CA
01
—
330204983
TAX ID
CA
01
—
PA18422
LISC.
CA
01
—
W10327
MCR GROUP ID
CA
Enumeration date
08/25/2006
Last updated
11/30/2021
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