Healthcare Provider Details

I. General information

NPI: 1932399029
Provider Name (Legal Business Name): KATTY SAHAKIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2048 MONTROSE AVE
MONTROSE CA
91020-1605
US

IV. Provider business mailing address

519 E BROADWAY
GLENDALE CA
91205-1110
US

V. Phone/Fax

Practice location:
  • Phone: 818-957-2224
  • Fax: 818-244-2261
Mailing address:
  • Phone: 818-409-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA106320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: