Provider Demographics
NPI:1114912615
Name:OSKOOI, FIROOZ REZAZADEH (MD)
Entity Type:Individual
Prefix:DR
First Name:FIROOZ
Middle Name:REZAZADEH
Last Name:OSKOOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 SANTIAGO DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3834
Mailing Address - Country:US
Mailing Address - Phone:949-642-9324
Mailing Address - Fax:
Practice Address - Street 1:1945 SANTIAGO DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3834
Practice Address - Country:US
Practice Address - Phone:949-642-9324
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41807207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C418071Medicaid
CAC-41807Medicare ID - Type Unspecified
CAA88282Medicare UPIN