MEDICARE: DR. ANGELO S. SADEGHPOUR MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A201061	CA
2	2084P0800X	Psychiatry Physician	ME157480	FL

General Provider Information

NPI Number	:	1790312650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELO S. SADEGHPOUR MD, PHD

Provider Business Mailing Address
First Line	:	1334 E MAIN ST
Second Line	:
City	:	SANTA PAULA
State	:	CA
Zip	:	93060-2926
Country	:	US
Telephone Number	:	805-933-1122
Fax Number	:

Provider Business Practice Location Address
First Line	:	1334 E MAIN ST
Second Line	:
City	:	SANTA PAULA
State	:	CA
Zip	:	93060-2926
Country	:	US
Telephone Number	:	805-933-1122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	03/11/2026

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