MEDICARE: DR. SEPER DEZFOLI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	036169574	IL
2	207RG0100X	Gastroenterology Physician	A113069	CA

General Provider Information

NPI Number	:	1104159383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEPER DEZFOLI M.D.

Provider Business Mailing Address
First Line	:	3816 WOODRUFF AVE STE 411
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2146
Country	:	US
Telephone Number	:	562-485-5550
Fax Number	:

Provider Business Practice Location Address
First Line	:	3816 WOODRUFF AVE STE 411
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2146
Country	:	US
Telephone Number	:	562-485-5550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2009
Last Update Date	:	03/09/2026

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Directions to “ DR. SEPER DEZFOLI M.D.” Practice Location

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