Rasouli, Reza
Rasouli, Reza is an individual health care provider with primary practice located at 1665 Scenic Ave Ste # 100, Costa Mesa CA 92626-1445. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Rasouli, Reza can be contacted via phone (714) 436-4444.Contact Information
Primary practice address
1665 Scenic Ave Ste # 100
Costa Mesa CA 92626-1445
Phone: (714) 436-4444
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 40509 | Tennessee |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | A85426 | California |
Profile Details
| NPI number | 1053395731 |
|---|---|
| LBN Legal business name | Rasouli, Reza |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 6th, 2005 |
| Last updated | Oct 30th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053395731 | NPPES |
| Louisiana | MEDICAID | 42346 |
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