MEDICARE: RUDY ROBERT REZZADEH 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	207RC0000X	Cardiovascular Disease Physician	C55967	CA

General Provider Information

NPI Number	:	1861558918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUDY ROBERT REZZADEH MD

Provider Business Mailing Address
First Line	:	1990 WESTWOOD BLVD STE 220
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4674
Country	:	US
Telephone Number	:	424-832-7110
Fax Number	:	424-832-7113

Provider Business Practice Location Address
First Line	:	1990 WESTWOOD BLVD
Second Line	:	SUITE 220
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4650
Country	:	US
Telephone Number	:	424-832-7110
Fax Number	:	424-832-7113

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

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	04/27/2026

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