Healthcare Provider Details

I. General information

NPI: 1063937092
Provider Name (Legal Business Name): SADIKAH BEHBEHANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 07/22/2024
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 NEWPORT BLVD STE 278
COSTA MESA CA
92627-2286
US

IV. Provider business mailing address

4350 VIA DEL OBISPO
YORBA LINDA CA
92886-3000
US

V. Phone/Fax

Practice location:
  • Phone: 929-200-9038
  • Fax:
Mailing address:
  • Phone: 480-265-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number54695
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: