Organization
ASHKAN ETEMADIAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHKAN ETEMADIAN MD (PRESIDENT)
(949) 701-2973
Entity
Organization
Contact information
Practice address
1 HOAG DR, NEWPORT BEACH, CA 92663-4162
(949) 764-4624
Mailing address
32565 B GOLDEN LANTERN, #167, DANA POINT, CA 92629
(949) 701-2973
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A105385
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A105385
STATE LICENSE NUMBER
CA
Enumeration date
05/06/2011
Last updated
05/06/2011
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