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Organization

NEW WAVE DERMATOLOGY AND LASER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BOBAK HEDAYATI MD (OWNER CEO)
(949) 395-6221
Entity
Organization

Contact information

Practice address
5010 CAMPUS DR # 140, NEWPORT BEACH, CA 92660-2120
(949) 395-6221
Mailing address
5010 CAMPUS DR # 140, NEWPORT BEACH, CA 92660-2120
(949) 395-6221

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary

Other

Enumeration date
03/07/2025
Last updated
11/01/2025
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