Manouchehr Seyfzadeh, M.D., PH.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A062453 Issued in CA

Practice address

1820 Fullerton Avenue
Ste 360
Corona, CA 92881-3106

Phone

(951) 270-4494

Fax

(951) 270-4495

NPI assigned

May 9, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

Un of California, Irvine, College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

MPZ DermatologyGroup PAC ID 6608317581, 3 clinicians

Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101
• Essentia Health Hospital, Fargo, ND, CCN 350070

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MPZ Dermatology

  • Dermatology Physician
  • Corona, CA
  • NPI 1790516623
  Medicare reassignment Care Compare group NPD
• Riverside Medical Clinic, Inc

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403
  Medicare reassignment Care Compare group NPD
• St. Marys Regional Health Center

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Medicare reassignment Care Compare group NPD
• Riverside Medical Clinic, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415

  Dermatology

  NPD
• Riverside Medical Clinic, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1982013884
  NPD
• St Mary'S Regional Health Center

  • Family Medicine Physician
  • Detroit Lakes, MN
  • NPI 1639513377
  NPD
• St Mary'S Regional Health Center

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482
  NPD
• J Robert West, M.D., Inc

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1932154788
  NPD (past)
• Murad Medical Group

  • Specialist
  • El Segundo, CA
  • NPI 1831154699
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation
• St Mary'S Regional Health Center

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482

  Hospital

  Care Compare affiliation
• St Marys Regional Health Center

  • Rural Health Clinic/Center
  • Park Rapids, MN
  • NPI 1730706656

  Hospital

  Care Compare affiliation
• St. Marys Regional Health Center

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1306895974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25422 TRABUCO RD STE 105-333",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302791",
            "telephone_number": "949-855-4439",
            "fax_number": "888-978-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 FULLERTON AVENUE",
            "address_2": "STE 360",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813106",
            "telephone_number": "951-270-4494",
            "fax_number": "951-270-4495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7160 Brockton Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925062620",
            "country_code": "US",
            "telephone_number": "951-782-3837",
            "fax_number": "951-328-9758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEYFZADEH",
        "first_name": "MANOUCHEHR",
        "name_prefix": "Mr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A062453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPIN",
            "identifier": "WA62453B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justina Servantes
• Michelle Servin, R1193480315
• Seth Bernstein OD and Lisa Benham OD Inc
• Cameron Lorraine Severns
• Jordyn Seward
• SG Homecare,Inc.
• Ahmed A Shaalan
• Priti Shah-Mistry, PSY.D.
• Kiran K Shah, DDS
• Krutika Anish Shah, D.D.S.

• Dermatology Physician in Corona, CA
• Providers in Corona, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.