| Reza Rasouli Md Inc | |
|
17100 Euclid St Fountain Valley CA 92708-4004 | |
| (714) 298-8118 | |
| Not Available |
| Full Name | Reza Rasouli Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17100 Euclid St, Fountain Valley, California |
| Authorized Official Name and Position | Reza Rasouli (CEO) |
| Authorized Official Contact | 7142988118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reza Rasouli Md Inc Po Box 27793 Anaheim CA 92809-0126 Ph: (714) 298-8118 | Reza Rasouli Md Inc 17100 Euclid St Fountain Valley CA 92708-4004 Ph: (714) 298-8118 |
| NPI Number | 1982477634 |
|---|---|
| Provider Enumeration Date | 11/03/2023 |
| Last Update Date | 11/03/2023 |
| Medicare PECOS PAC ID | 7416305495 |
|---|---|
| Medicare Enrollment ID | O20231201000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982477634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Reza Rasouli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053395731 PECOS PAC ID: 0941246359 Enrollment ID: I20070515000494 |
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