Provider Demographics
NPI:1306043161
Name:HOVEYDA, ALIREZA (PT)
Entity Type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:
Last Name:HOVEYDA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12110 SMALLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2331
Mailing Address - Country:US
Mailing Address - Phone:562-861-5349
Mailing Address - Fax:562-862-4045
Practice Address - Street 1:12110 SMALLWOOD AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2331
Practice Address - Country:US
Practice Address - Phone:562-861-5349
Practice Address - Fax:562-862-4045
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 248402251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics