Individual
ALI R SEPAHDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 301-6800
Mailing address
5767 W CENTURY BLVD, STE 400, LOS ANGELES, CA 90045-5631
(310) 301-6800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036117841
IL
2085R0202X
Diagnostic Radiology Physician
Primary
A113928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001088601
MEDICARE PROVIDER
MA
01
—
001088602
MEDICARE ACD
MA
05
—
0A1139280
—
CA
05
—
2174341
—
MA
Enumeration date
04/13/2007
Last updated
02/11/2025
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