Provider Demographics
NPI:1053741298
Name:CYRUS SEDAGHAT, M.D., APMC
Entity type:Organization
Organization Name:CYRUS SEDAGHAT, M.D., APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:SHARUZ
Authorized Official - Last Name:SEDAGHAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-500-8388
Mailing Address - Street 1:18800 DELAWARE STREET
Mailing Address - Street 2:SUITE 670
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-7605
Mailing Address - Country:US
Mailing Address - Phone:714-500-8388
Mailing Address - Fax:714-500-8389
Practice Address - Street 1:18800 DELAWARE ST
Practice Address - Street 2:SUITE 670
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1959
Practice Address - Country:US
Practice Address - Phone:714-500-8388
Practice Address - Fax:714-500-8389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108751208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA108751OtherMEDICAL BOARD OF CALIFORNIA