Provider Demographics
NPI:1386962686
Name:REZAI, KAZI (DO)
Entity type:Individual
Prefix:DR
First Name:KAZI
Middle Name:
Last Name:REZAI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18672 FLORIDA ST
Mailing Address - Street 2:SUITE 302-B
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1925
Mailing Address - Country:US
Mailing Address - Phone:714-375-0691
Mailing Address - Fax:
Practice Address - Street 1:18672 FLORIDA ST
Practice Address - Street 2:SUITE 302-B
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1925
Practice Address - Country:US
Practice Address - Phone:714-375-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12157208D00000X, 204D00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine