MEDICARE: ANDRE BARZEGAR DSS

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	132700000X	Dietary Manager

General Provider Information

NPI Number	:	1629969464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRE BARZEGAR DSS

Provider Business Mailing Address
First Line	:	9162 MARCHAND AVE
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92841-2035
Country	:	US
Telephone Number	:	657-319-6665
Fax Number	:

Provider Business Practice Location Address
First Line	:	9162 MARCHAND AVE
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92841-2035
Country	:	US
Telephone Number	:	657-319-6665
Fax Number	:

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

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	07/10/2025

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Directions to “ ANDRE BARZEGAR DSS” Practice Location

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