Healthcare Provider Details

I. General information

NPI: 1154941771
Provider Name (Legal Business Name): AUTEFEH SADAT SAJJADI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S RODEO DR STE 360
BEVERLY HILLS CA
90212-2445
US

IV. Provider business mailing address

2320 SUTTER ST # 396
SAN FRANCISCO CA
94115-3038
US

V. Phone/Fax

Practice location:
  • Phone: 424-363-4112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberA201492
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA201492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: