Healthcare Provider Details

I. General information

NPI: 1063156131
Provider Name (Legal Business Name): MICHAEL SADIGHIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 04/25/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NORTH STATE STREET CLINIC TOWER, SUITE A7D
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

600 MINNESOTA ST UNIT 263
SAN FRANCISCO CA
94107-3027
US

V. Phone/Fax

Practice location:
  • Phone: 323-865-3716
  • Fax:
Mailing address:
  • Phone: 805-657-0071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: