Healthcare Provider Details

I. General information

NPI: 1649036237
Provider Name (Legal Business Name): ALIREZA GHOREIFI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SEYEDALIREZA GHOREIFINEJADIAN MD

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

101 THE CITY DR S
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-8111
  • Fax:
Mailing address:
  • Phone: 714-456-6379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberSPI-973
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: