Healthcare Provider Details

I. General information

NPI: 1063057230
Provider Name (Legal Business Name): SEPIDEH SABER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16542 VENTURA BLVD STE 302
ENCINO CA
91436-5030
US

IV. Provider business mailing address

16542 VENTURA BLVD STE 302
ENCINO CA
91436-5030
US

V. Phone/Fax

Practice location:
  • Phone: 818-770-7050
  • Fax: 818-770-7050
Mailing address:
  • Phone: 818-770-7050
  • Fax: 818-770-7051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SEPIDEH SABER
Title or Position: OWNER
Credential: MD
Phone: 818-770-7050