Individual
REZA MAHROU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
113 WATERWORKS WAY, SUITE 345, IRVINE, CA 92618-3167
(949) 872-2400
(949) 872-2401
Mailing address
PO BOX 54788, IRVINE, CA 92619-4788
(949) 872-2400
(949) 872-2401
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A76865
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A76865
STATE LICENSE
CA
Enumeration date
06/18/2006
Last updated
02/29/2012
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