Healthcare Provider Details

I. General information

NPI: 1336186725
Provider Name (Legal Business Name): KEYVAN ZAVAREI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3754 FALCONHEAD DR
RANCHO PALOS VERDES CA
90275-6129
US

IV. Provider business mailing address

3754 FALCONHEAD DR
RANCHO PALOS VERDES CA
90275-6129
US

V. Phone/Fax

Practice location:
  • Phone: 949-836-7665
  • Fax: 949-272-3746
Mailing address:
  • Phone: 949-836-7665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA88805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: