REZA SEPEHRDAD (NPI# 1891973566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891973566 |
| Entity Type | Individual |
| Full Name | REZA SEPEHRDAD |
| Credential | M.D. |
| Practice Address |
999 S Fairmont Ave Suite 130 Lodi CA 95240-5100 |
| Mailing Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2093662001 |
| Mailing Telephone | 2095216097 |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2016-01-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | A102642 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A102642 | CA | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
A102642 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
999 S FAIRMONT AVE SUITE 130 |
| City | LODI |
| State | CA |
| Zip Code | 95240-5100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962401901 | Nicole Tate | Obstetrics & Gynecology | 999 S Fairmont Ave, Suite 225, Lodi, CA 95240-5100 | 2005-07-20 |
| 1629516620 | Ht Family Physicians | Family Medicine | 999 S Fairmont Ave, Suite 215, Lodi, CA 95240-5100 | 2017-02-09 |
| 1730531468 | Adventist Health Physicians Network | Internal Medicine | 999 S Fairmont Ave, Suite #125, Lodi, CA 95240-5100 | 2016-07-06 |
| 1780033084 | Adventist Health Physicians Network | Surgery | 999 S Fairmont Ave, Suite#100, Lodi, CA 95240-5100 | 2016-06-07 |
| 1245629526 | P. Gill Obsteterics & Gynecology Medical Group, Inc | Registered Nurse | 999 S Fairmont Ave, Ste. 230, Lodi, CA 95240-5100 | 2015-01-09 |
| 1598183444 | Patricia Lynn Kennel | Internal Medicine | 999 S Fairmont Ave, Lodi, CA 95240-5100 | 2014-03-28 |
| 1215359534 | Deborah Planchard | Audiologist | 999 S Fairmont Ave, Suite 215, Lodi, CA 95240-5100 | 2014-01-07 |
| 1851650469 | Alecia Nicole Russell | Obstetrics & Gynecology | 999 S Fairmont Ave, Ste. 230, Lodi, CA 95240-5100 | 2012-05-16 |
| 1396018727 | Lodi Memorial Hospital Association Inc | Clinic/Center | 999 S Fairmont Ave, Suite 100, Lodi, CA 95240-5100 | 2012-02-15 |
| 1851684930 | Rajeev Shukla Md Inc | Internal Medicine | 999 S Fairmont Ave, Suite 135, Lodi, CA 95240-5100 | 2011-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034991 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1139 E. Kettleman Lane, Suite 101, Lodi, CA 95240 | 2020-02-07 |
| 1548747082 | Gill and Patel Dental Corporation | Dentist | 2610 Reynolds Ranch Pkwy, Ste 100, Lodi, CA 95240 | 2018-07-27 |
| 1629511308 | Jose Daniel Garcia | Licensed Vocational Nurse | 12755 Ca-88, Lodi, CA 95240 | 2016-11-29 |
| 1104372754 | Jocelyn Janel Shilue | Specialist/Technologist | 705 Brandywine Drive, Lodi, CA 95240 | 2016-09-01 |
| 1750735965 | Natharchia R Peoples | Counselor | 9150 Ca-12, Lodi, CA 95240 | 2016-04-14 |
| 1891189403 | Valley Community Couseling Services | Case Management | 1300 W. Lodi Ste G-2, Stockton, CA 95240 | 2015-03-20 |
| 1114317195 | Carol Kooyman | Speech-Language Pathologist | 831 So. Lee Ave., Lodi, CA 95240 | 2015-01-29 |
| 1730514464 | Richard Barry Sirard | Pharmacist | 520 S Cherokee Lane, Lodi, CA 95240 | 2013-09-12 |
| 1740622570 | Joshlynn Uribe | Marriage & Family Therapist | 13520 E Live Oak Rd, Lodi, CA 95240 | 2013-07-22 |
| 1902172406 | Sital Singh | Internal Medicine | 999 S Fairmont Ave Ste 125, Lodi, CA 95240 | 2012-03-29 |
| Find all providers in zip 95240 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710012117 | Elizabeth Ann Hereford | Internal Medicine | 999 S Fairmont Ave Ste 220, Lodi, CA 95240-5142 | 2007-02-23 |
| 1225034416 | Steven D. La Viola | Internal Medicine | 845 S Fairmont Ave, Suite 8, Lodi, CA 95240-5113 | 2005-06-22 |
| 1780688515 | Steven Jay Block | Internal Medicine | 777 S Ham Ln, Ste G, Lodi, CA 95242-3593 | 2005-06-09 |
| 1780936906 | George V Dous | Internal Medicine | 999 S Fairmont Ave Ste 130, Lodi, CA 95240 | 2012-10-11 |
| 1063690717 | Harpreet Singh Parmar | Internal Medicine | 999 S Fairmont Ave Ste 130, Lodi, CA 95240-5141 | 2008-02-05 |
| 1740352723 | David Joseph Magorien | Internal Medicine | 999 S Fairmont Ave, Suite 130, Lodi, CA 95240-5100 | 2006-11-14 |
| 1699784637 | Lodi Internist Group Pa | Internal Medicine | 361 Garibaldi Ave, Lodi, NJ 07644-3709 | 2006-08-07 |
| 1790712990 | Pacific Heart and Vascular Medical Group | Internal Medicine | 845 S Fairmont Ave, Suite 11, Lodi, CA 95240-5113 | 2006-06-26 |
| 1124067160 | Partners Physician Group | Internal Medicine | 225 Elyria St, Lodi, OH 44254-1031 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962000141 | Suman S Kuppahally, M.d. Inc | Internal Medicine | 2505 Samaritan Dr Ste 600, San Jose, CA 95124-4017 | 2020-10-11 |
| 1336754472 | Ankur Gupta Medical Corporation | Internal Medicine | 820 S Akers St Ste 130, Visalia, CA 93277-8346 | 2020-09-15 |
| 1295351740 | Penciu Medical Apmc | Internal Medicine | 1585 Sierra Madre Villa Ave, Pasadena, CA 91107-1259 | 2020-06-21 |
| 1679113336 | La Pulse Medical, Inc | Internal Medicine | 14558 Sylvan St Ste 105, Van Nuys, CA 91411-2324 | 2020-01-10 |
| 1770122871 | John R. Nelson M.d. Inc. | Internal Medicine | 7061 N Whitney Ave Ste 101, Fresno, CA 93720-8025 | 2020-01-06 |
| 1730725789 | Norcal Medical Services, Inc | Internal Medicine | 2267 Lava Ridge Ct, Roseville, CA 95661-3062 | 2019-11-25 |
| 1932750957 | Enloe Medical Center | Internal Medicine | 1430 Esplanade Ste 6, Chico, CA 95926-3366 | 2019-09-20 |
| 1528610425 | Nicholas Russell | Internal Medicine | 2967 N Moorpark Rd, Thousand Oaks, CA 91360-4573 | 2019-07-10 |
| 1043871627 | Gy Medical Clinic Inc | Internal Medicine | 7400 Van Nuys Blvd Ste 112, Van Nuys, CA 91405-1972 | 2019-06-25 |
| 1902465792 | Pacific Heart & Vascular | Internal Medicine | 1234 W. Chapman Ave, Ste #101, Orange, CA 92868-2862 | 2019-06-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on REZA SEPEHRDAD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.