Provider Demographics
NPI:1760432801
Name:VAGEFI, M REZA (MD)
Entity Type:Individual
Prefix:DR
First Name:M REZA
Middle Name:
Last Name:VAGEFI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10 KORET WAY
Mailing Address - Street 2:ROOM K201
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0730
Mailing Address - Country:US
Mailing Address - Phone:415-476-1922
Mailing Address - Fax:415-514-3986
Practice Address - Street 1:400 PARNASSUS AVE
Practice Address - Street 2:SUITE A750
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:415-353-2142
Practice Address - Fax:415-514-6034
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT61218121205207W00000X, 2086S0122X
PAMD434362207W00000X
CAA84915207W00000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery