Healthcare Provider Details

I. General information

NPI: 1578676300
Provider Name (Legal Business Name): SANGEETA C LOGANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16661 VENTURA BLVD STE 826
ENCINO CA
91436-4803
US

IV. Provider business mailing address

16661 VENTURA BLVD STE 826
ENCINO CA
91436-4803
US

V. Phone/Fax

Practice location:
  • Phone: 818-477-0560
  • Fax: 408-724-6592
Mailing address:
  • Phone: 818-477-0560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberG75525
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: