Provider Demographics
NPI:1427409820
Name:MOHEBBI, AMIR (MD)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:MOHEBBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AMIR
Other - Middle Name:
Other - Last Name:MOHEBBI ABIVARDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:314 S HENDERSON RD STE G
Mailing Address - Street 2:PMB 332
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2449
Mailing Address - Country:US
Mailing Address - Phone:949-456-3600
Mailing Address - Fax:
Practice Address - Street 1:145 N 6TH STREET
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3096
Practice Address - Country:US
Practice Address - Phone:610-406-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4855012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry