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Individual

DR. DAMOUN A REZAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., M.H.A.

Contact information

Practice address
69175 RAMON RD BLDG A, CATHEDRAL CITY, CA 92234-3344
(760) 321-6776
Mailing address
69175 RAMON RD BLDG A, CATHEDRAL CITY, CA 92234-3344
(760) 321-6776

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A138824
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07738172
ECFMG
CA
01
1619300761
NPI
CA
01
A138824
MEDICAL LIC
CA
01
D2728162
CA DRIVERS LICENSE
CA
Enumeration date
08/13/2013
Last updated
03/07/2023
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