Provider Demographics
NPI:1760825806
Name:REJAI, SEPEHR (MD)
Entity Type:Individual
Prefix:
First Name:SEPEHR
Middle Name:
Last Name:REJAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2350 W EL CAMINO REAL FL 2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-6203
Mailing Address - Country:US
Mailing Address - Phone:510-204-8140
Mailing Address - Fax:510-506-7721
Practice Address - Street 1:2850 TELEGRAPH AVE STE 120
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:510-204-8140
Practice Address - Fax:510-506-7721
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA134426208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA134426OtherSTATE MEDICAL LICENSE
CAFR7694614OtherFEDERAL DEA LICENSE