M T Rezai PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

M T REZAI PC

Practice address

27154 Sea Vista Dr
Malibu, CA 90265-4437

Phone

(818) 458-0917

NPI assigned

Oct 8, 2019

Last updated

Dec 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohammed Rezai, DONPI 1013399195

Title

Physician Owner

Phone

(818) 458-0917

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammed Taghi Rezai, D.O.

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1013399195

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1437791704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E THOUSAND OAKS BLVD STE B",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605800",
            "telephone_number": "818-232-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27154 SEA VISTA DR",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654437",
            "telephone_number": "818-458-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M T REZAI PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "REZAI",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "818-458-0917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Los Angeles County Department of Mental Health (Campus Vernon Kilpatrick)
• Heather Ashly Louks, L.AC
• Luminance Health Group, Inc.
• Luxury Rehab Group, LLC. (Seasons in Malibu)
• Xuan Ly, MS, SLP-CCC
• Michael Maguire, AC
• Malibu Beach Recovery Center, LLC
• Malibu Beach Recovery Center, LLC (RiverMend Health, LLC)
• Malibu Detox, LLC.
• Malibu Hills Treatment Corp

• Primary Care Clinic/Center in Malibu, CA
• Providers in Malibu, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.