MEDICARE: SEPIDEH MOAYED MD

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	2085P0229X	Pediatric Radiology Physician	A77967	CA
2	2085R0202X	Diagnostic Radiology Physician	A77967	CA
3	2085U0001X	Diagnostic Ultrasound Physician	A77967	CA
4	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
5	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	A77967	CA
6	2085B0100X	Body Imaging Physician	A77967	CA
7	2083S0010X	Sports Medicine (Preventive Medicine) Physician	A77967	CA
8	2085N0700X	Neuroradiology Physician	A77967	CA

General Provider Information

NPI Number	:	1295709046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEPIDEH MOAYED MD

Provider Business Mailing Address
First Line	:	2242 CAMDEN AVE STE 203
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2029
Country	:	US
Telephone Number	:	408-992-5141
Fax Number	:	408-796-7492

Provider Business Practice Location Address
First Line	:	2242 CAMDEN AVE STE 203
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2029
Country	:	US
Telephone Number	:	408-992-5141
Fax Number	:	408-796-7492

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

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	03/12/2021

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Directions to “ SEPIDEH MOAYED MD” Practice Location

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