Healthcare Provider Details

I. General information

NPI: 1033387170
Provider Name (Legal Business Name): ALIREZA JAFARI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14350 WHITTIER BLVD STE 310
WHITTIER CA
90605-2152
US

IV. Provider business mailing address

10053 WHITTWOOD DR UNIT 1218
WHITTIER CA
90609-0412
US

V. Phone/Fax

Practice location:
  • Phone: 562-945-7746
  • Fax: 562-945-6619
Mailing address:
  • Phone: 562-945-7746
  • Fax: 562-945-6619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA49135
License Number StateCA

VIII. Authorized Official

Name: ALIREZA JAFARI
Title or Position: PRESIDENT
Credential: MD
Phone: 562-945-7746