MEDICARE: DIVYA SACHDEV MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	A129988	CA

General Provider Information

NPI Number	:	1316204936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIVYA SACHDEV MD

Provider Business Mailing Address
First Line	:	2285 CORPORATE CIR STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7759
Country	:	US
Telephone Number	:	702-360-2763
Fax Number	:	949-783-2880

Provider Business Practice Location Address
First Line	:	23550 HAWTHORNE BLVD STE 200
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90505-4722
Country	:	US
Telephone Number	:	310-373-2636
Fax Number	:	310-373-2633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2012
Last Update Date	:	01/05/2022

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Directions to “ DIVYA SACHDEV MD” Practice Location

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