Provider Demographics
NPI:1376511188
Name:HAMZEI, ALI REZA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:REZA
Last Name:HAMZEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230757
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-0757
Mailing Address - Country:US
Mailing Address - Phone:760-944-7300
Mailing Address - Fax:760-634-6564
Practice Address - Street 1:320 SANTA FE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5138
Practice Address - Country:US
Practice Address - Phone:760-944-7300
Practice Address - Fax:760-633-3949
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62682207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A626820Medicaid
CAE6524OtherMEDI-CAL NUMBER
WA62682AMedicare PIN
CA00A626820Medicaid