Provider Type Icon

MICHAEL BABAK MORTAZIE DO NPI 1457616914


NPI Information

NPI: 1457616914
Provider Name: MICHAEL BABAK MORTAZIE, DO
Classification: Dermatology - 207ND0101X
Entity Type: Individual

Specialization: MOHS-Micrographic Surgery

PECOS Registration: Yes

CLIA Number: 05D0678585

Address:
1506 E CHAPMAN AVE
ORANGE, CA
ZIP 92866
Phone: (714) 538-8556
Get Directions

Michael Babak Mortazie, DO is a mohs-micrographic surgery dermatology in Orange, CA with 12 years of experience. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. Michael Babak Mortazie, DO NPI is 1457616914. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduation Year:2012

The provider's business location address is:

1506 E CHAPMAN AVE
ORANGE, CA
ZIP 92866-231
Phone: (714) 538-8556
Fax: (714) 538-1082

The NPI 1457616914 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D0678585 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/11/2012 and was last updated on 9/17/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic Surgery14600CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.