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General NPI Number Information
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NPI Number | 1720675598
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Entity Type | Individual
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Provider Name | SEPEHR REZAEI DPT
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Gender | Male
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Dates
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Enumeration Date | 12/28/2020
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 1594 S IMPERIAL AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-4241
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Country | US
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Telephone | 760-344-9180
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Fax |
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Provider Business Mailing Address
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Address Line | 5160 E PARKER ST
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City | OCEANSIDE
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State | CA
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Zip | 92057-3615
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Country | US
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Telephone | 760-960-5777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 299676
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License Number State | CA
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