Provider Demographics
NPI:1285716316
Name:BATHAEE, FARSHAD (DPM)
Entity type:Individual
Prefix:DR
First Name:FARSHAD
Middle Name:
Last Name:BATHAEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 OLD NEWPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4210
Mailing Address - Country:US
Mailing Address - Phone:949-491-9991
Mailing Address - Fax:949-612-9795
Practice Address - Street 1:3300 W COAST HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4026
Practice Address - Country:US
Practice Address - Phone:949-491-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5187213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1615659-001OtherCIGNA HMO
VA2813310OtherAETNA HMO
VA461953OtherANTHEM BCBS
VA573317OtherOPTIMUM CHOICE
VA1615659OtherCIGNA PPO
VA69130001OtherCAREFIRST BCBS
VA76601OtherAMERIGROUP MEDICAID HMO
VA27-00646OtherUNITED HEALTH CARE
VA740716OtherAETNA PPO
VA7431615659OtherCIGNA POS
VA76601OtherAMERIGROUP MEDICAID HMO
VA76601OtherAMERIGROUP MEDICAID HMO
VA9304738Medicaid