Individual provider Active NPI

Fariborz Razavi Rezagholi

  • Acupuncturist
  • Irvine, CA
National Provider Identifier
1669278719
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC18609 Issued in CA
Practice address
21 Bear Paw
21A
Irvine, CA 92604
Phone
(949) 400-6588
NPI assigned
Feb 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC18609 CA Primary

Addresses

Primary practice location

21 Bear Paw
21A
Irvine, CA 92604

Mailing address

21 Bear Paw
21A
Irvine, CA 92604
Phone (949) 400-6588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC18609CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1669278719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BEAR PAW",
            "address_2": "21A",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92604",
            "telephone_number": "949-400-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BEAR PAW",
            "address_2": "21A",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92604",
            "telephone_number": "949-400-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZAVI REZAGHOLI",
        "first_name": "FARIBORZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC18609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.