| Mokhtare Md, Professional Corporation | |
|
2865 E Coast Hwy Unit 120 Corona Del Mar CA 92625-2236 | |
| (866) 278-2204 | |
| Not Available |
| Full Name | Mokhtare Md, Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 2865 E Coast Hwy Unit 120, Corona Del Mar, California |
| Authorized Official Name and Position | Shahrzad Mokhtare (PRESIDENT) |
| Authorized Official Contact | 9497351632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mokhtare Md, Professional Corporation 3141 Michelson Dr Unit 1704 Irvine CA 92612-5675 Ph: (949) 287-6357 | Mokhtare Md, Professional Corporation 2865 E Coast Hwy Unit 120 Corona Del Mar CA 92625-2236 Ph: (866) 278-2204 |
| NPI Number | 1205652146 |
|---|---|
| Provider Enumeration Date | 11/25/2024 |
| Last Update Date | 10/24/2025 |
| Medicare PECOS PAC ID | 8022548015 |
|---|---|
| Medicare Enrollment ID | O20250205003642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205652146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shahrzad Mokhtare |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912481334 PECOS PAC ID: 0244615797 Enrollment ID: I20220919003356 |
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