Provider Demographics
NPI:1518974583
Name:KAZEMI, SEPIDEH (MD)
Entity Type:Individual
Prefix:MS
First Name:SEPIDEH
Middle Name:
Last Name:KAZEMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3706
Mailing Address - Country:US
Mailing Address - Phone:949-453-9393
Mailing Address - Fax:949-453-9494
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 601
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3706
Practice Address - Country:US
Practice Address - Phone:949-453-9393
Practice Address - Fax:949-453-9494
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94770207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1295093490Medicaid