| Perry B. Sheidayi, D.o., Professional Corporation | |
|
18 Endeavor Ste 201 Irvine CA 92618-3181 | |
| (949) 650-5771 | |
| (949) 340-3967 |
| Full Name | Perry B. Sheidayi, D.o., Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 18 Endeavor Ste 201, Irvine, California |
| Authorized Official Name and Position | Perry Behrooz Sheidayi (PRESIDENT) |
| Authorized Official Contact | 9496505771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perry B. Sheidayi, D.o., Professional Corporation 18 Endeavor Ste 201 Irvine CA 92618-3181 Ph: (949) 650-5771 | Perry B. Sheidayi, D.o., Professional Corporation 18 Endeavor Ste 201 Irvine CA 92618-3181 Ph: (949) 650-5771 |
| NPI Number | 1477665875 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 02/18/2020 |
| Medicare PECOS PAC ID | 0446243141 |
|---|---|
| Medicare Enrollment ID | O20040407001075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477665875 | NPI | - | NPPES |
| W17052 | Other | CA | MEDICARE ID |
| 00AX78000 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A7800 (California) | Primary |
| Provider Name | Perry B Sheidayi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508823519 PECOS PAC ID: 7315930021 Enrollment ID: I20040407001145 |
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