Healthcare Provider Details

I. General information

NPI: 1770883050
Provider Name (Legal Business Name): HOMAYOUN SADEGHI, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 S. BEVERLY DRIVE #3861
BEVERLY HILLS CA
90212-0861
US

IV. Provider business mailing address

PO BOX 3861
BEVERLY HILLS CA
90212-0861
US

V. Phone/Fax

Practice location:
  • Phone: 310-278-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: HOMAYOUN SADEGHI
Title or Position: MD
Credential:
Phone: 310-278-5700