Sepehr Rezaei, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

299676 Issued in CA

Practice address

1594 S Imperial Ave
El Centro, CA 92243-4241

Phone

(760) 344-9180

NPI assigned

Dec 28, 2020

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 names 1

• Dr. Sepehr Bruce Rezaei Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1720675598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5160 E PARKER ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920573615",
            "telephone_number": "760-960-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 S IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434241",
            "telephone_number": "760-344-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAEI",
        "first_name": "SEPEHR",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-28",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEPEHR",
            "last_name": "REZAEI",
            "middle_name": "BRUCE",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapist in El Centro, CA
• Providers in El Centro, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.