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M T REZAI PC
NPI 1437791704
Clinic/Center - Primary Care in Malibu, CA

Active since October 08, 2019CLIA 05D2191038 · Waiver
27154 SEA VISTA DR, MALIBU, CA 90265(818) 458-0917 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2021, Oct 8, 2019 (2 updates tracked since 2019).

About M T Rezai Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

M T REZAI PC (NPI 1437791704) is a healthcare organization registered as a primary care in Malibu, California and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through August 20, 2026 and lists Mohammed Rezai, Physician Owner, as its authorized official.

NPPES Registry Identity

NPI1437791704
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameM T REZAI PC
Location Address27154 SEA VISTA DRMalibu, CA 90265-4437
Mailing Address455 E Thousand Oaks Blvd Ste BThousand Oaks, CA 91360-5800 · (818) 232-5788
Phone(818) 458-0917
Organization SubpartNo
Authorized OfficialMohammed RezaiPhysician Owner · (818) 458-0917
Enumeration DateOctober 8, 2019
Last NPPES UpdateDecember 3, 20212 updates tracked since enumeration
NPPES CertifiedDecember 3, 2021
✔ NPI 1437791704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
27154 SEA VISTA DR, Malibu, CA 90265
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2191038

M T Rezai, PC · Thousand Oaks, CA
Active · expires Aug 20, 2026
CLIA Number05D2191038
Laboratory TypePhysician Office
Certificate Effective DateAugust 21, 2024
Certificate Expiration DateAugust 20, 2026
Laboratory DirectorRezai Mohammed
Laboratory Phone(818) 458-0917
Laboratory LocationM T Rezai, PC455 East Thousand Oaks Blvd Suite B, Thousand Oaks, CA 91360
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is M T Rezai PC's NPI number?

The NPI number for M T Rezai PC is 1437791704. It was assigned to this organization in the NPPES registry on October 8, 2019.

Where is M T Rezai PC located?

M T Rezai PC is located at 27154 Sea Vista Dr, Malibu, CA 90265. The listed phone number is (818) 458-0917.

What is M T Rezai PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does M T Rezai PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2191038) is associated with this NPI, valid through August 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for M T Rezai PC was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.