Provider Demographics
NPI:1487103057
Name:DAH M.D. MEDICAL CORP.
Entity type:Organization
Organization Name:DAH M.D. MEDICAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZUBIN
Authorized Official - Middle Name:MEHERNOSH
Authorized Official - Last Name:DAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC LAC
Authorized Official - Phone:949-679-6922
Mailing Address - Street 1:10 CORPORATE PARK
Mailing Address - Street 2:SUITE 230
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-5140
Mailing Address - Country:US
Mailing Address - Phone:949-679-6922
Mailing Address - Fax:949-679-6974
Practice Address - Street 1:10 CORPORATE PARK
Practice Address - Street 2:SUITE 230
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5140
Practice Address - Country:US
Practice Address - Phone:949-679-6922
Practice Address - Fax:949-679-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31448332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A314480Medicaid
CACB243338Medicare PIN
CAA26486Medicare UPIN