Healthcare Provider Details

I. General information

NPI: 1871547075
Provider Name (Legal Business Name): SEPIDEH CHEGINI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SEPIDEH FARAHANI

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 LAKEWOOD BLVD
DOWNEY CA
90240-4020
US

IV. Provider business mailing address

12900 PARK PLAZA DR SUITE 150
CERRITOS CA
90703-9329
US

V. Phone/Fax

Practice location:
  • Phone: 562-862-3684
  • Fax: 562-862-7145
Mailing address:
  • Phone: 562-741-4421
  • Fax: 562-741-4479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA78691
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: