Healthcare Provider Details

I. General information

NPI: 1376967778
Provider Name (Legal Business Name): SARA KHAN JANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10772 JEFFERSON BLVD
CULVER CITY CA
90230-4933
US

IV. Provider business mailing address

10772 JEFFERSON BLVD
CULVER CITY CA
90230-4933
US

V. Phone/Fax

Practice location:
  • Phone: 310-836-2684
  • Fax: 310-836-1598
Mailing address:
  • Phone: 310-836-2684
  • Fax: 310-836-1598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberCA52849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: