Provider Demographics
NPI:1285830315
Name:BABAI, DORSA (DO)
Entity type:Individual
Prefix:DR
First Name:DORSA
Middle Name:
Last Name:BABAI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 MISSION
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3419
Mailing Address - Country:US
Mailing Address - Phone:949-400-8823
Mailing Address - Fax:815-846-1694
Practice Address - Street 1:94 MISSION
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3419
Practice Address - Country:US
Practice Address - Phone:949-400-8823
Practice Address - Fax:815-846-1694
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine