Healthcare Provider Details

I. General information

NPI: 1669376604
Provider Name (Legal Business Name): SAHAR EIVAZ MOHAMMADI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S WEIR CANYON RD STE 157-383
ANAHEIM CA
92808-1962
US

IV. Provider business mailing address

751 S WEIR CANYON RD STE 157-383
ANAHEIM CA
92808-1962
US

V. Phone/Fax

Practice location:
  • Phone: 951-633-1332
  • Fax:
Mailing address:
  • Phone: 951-633-1332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SAHAR EIVAZ MOHAMMADI
Title or Position: OWNER
Credential: MD
Phone: 951-633-1332