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General NPI Number Information
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NPI Number | 1780875393
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Entity Type | Individual
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Provider Name | HAMID REZA REDJAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 401 E CARRILLO ST
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City | SANTA BARBARA
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State | CA
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Zip | 93101-1460
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Country | US
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Telephone | 805-563-3307
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Fax | 805-563-0998
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Provider Business Mailing Address
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Address Line | 1523 CALLE PATRICIA
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-1939
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Country | US
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Telephone | 573-388-3030
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Fax | 573-335-8424
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A99471
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2012037238
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License Number State | MO
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