Provider Demographics
NPI:1316990294
Name:BAYATI, SEMIRA (MD)
Entity type:Individual
Prefix:DR
First Name:SEMIRA
Middle Name:
Last Name:BAYATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20311 SW BIRCH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1777
Mailing Address - Country:US
Mailing Address - Phone:949-756-0400
Mailing Address - Fax:949-756-0428
Practice Address - Street 1:20311 SW BIRCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1777
Practice Address - Country:US
Practice Address - Phone:949-756-0400
Practice Address - Fax:949-756-0428
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG842412082S0105X, 2086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG84241Medicare ID - Type Unspecified
CAH01892Medicare UPIN