Provider Demographics
NPI:1447437769
Name:SAREMI, KAVEH (MD)
Entity type:Individual
Prefix:DR
First Name:KAVEH
Middle Name:
Last Name:SAREMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3524
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90510
Mailing Address - Country:US
Mailing Address - Phone:310-809-5995
Mailing Address - Fax:949-650-4241
Practice Address - Street 1:19582 BEACH BLVD STE 270
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5924
Practice Address - Country:US
Practice Address - Phone:714-718-0988
Practice Address - Fax:949-669-1510
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CAA1026032084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A1026030Medicaid
CA0A1026030Medicaid