Basic Information
| Provider Information | |||||||||
| NPI: | 1528078672 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORSHEDIZADEH | ||||||||
| FirstName: | KASRA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 845 W LA VETA AVE STE 108 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146392600 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 845 W LA VETA AVE STE 108 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146392600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 11/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | A90985 | CA | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | A90985 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.