MEDICARE: DR. SEYED ALIREZA SADEGHI 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	207Q00000X	Family Medicine Physician	M.D.203025	LA
2	207P00000X	Emergency Medicine Physician	180617	CA

General Provider Information

NPI Number	:	1710195144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEYED ALIREZA SADEGHI M.D.

Provider Business Mailing Address
First Line	:	104 ALBERTSON PKWY STE 6
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-5325
Country	:	US
Telephone Number	:	337-330-2339
Fax Number	:	337-330-2352

Provider Business Practice Location Address
First Line	:	753 ODD FELLOWS RD STE F
Second Line	:
City	:	CROWLEY
State	:	LA
Zip	:	70526-2200
Country	:	US
Telephone Number	:	337-514-5233
Fax Number	:	337-514-5235

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

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	03/29/2023

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