Healthcare Provider Details

I. General information

NPI: 1689869257
Provider Name (Legal Business Name): DR. SAUNAZ SARVI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 BERKELEY SQARE
BERKELEY CA
94704
US

IV. Provider business mailing address

6363 CHRISTIE AVE APT#1512
EMERYVILLE CA
94608-1914
US

V. Phone/Fax

Practice location:
  • Phone: 510-540-8400
  • Fax: 510-540-0609
Mailing address:
  • Phone: 800-417-4444
  • Fax: 714-571-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number55610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: