Healthcare Provider Details

I. General information

NPI: 1841495538
Provider Name (Legal Business Name): SEPIDEH ZAHEDY-KAPUSTA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 W LA HABRA BLVD
LA HABRA CA
90631-5007
US

IV. Provider business mailing address

17125 SWEETBAY CT..
YORBA LINDA CA
92886-0000
US

V. Phone/Fax

Practice location:
  • Phone: 562-697-1001
  • Fax: 562-697-1002
Mailing address:
  • Phone: 714-369-8659
  • Fax: 714-534-5938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA99099
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA99099
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License NumberA99099
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA99099
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA99099
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA99099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: