Healthcare Provider Details

I. General information

NPI: 1710195144
Provider Name (Legal Business Name): SEYED ALIREZA SADEGHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALI SADEGHI M.D.

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S OAK AVE
OAKDALE CA
95361-3519
US

IV. Provider business mailing address

4 PENINSULA
NEWPORT COAST CA
92657-1516
US

V. Phone/Fax

Practice location:
  • Phone: 985-381-6758
  • Fax:
Mailing address:
  • Phone: 985-381-6758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM.D.203025
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number180617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: