Healthcare Provider Details

I. General information

NPI: 1144268657
Provider Name (Legal Business Name): DR. MEHBOOB ANWERALI SACHANI
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: MEHBOOB ANWERALI SACHANI M.D.

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18433 ROSCOE BLVD SUITE 203
NORTHRIDGE CA
91325-4108
US

IV. Provider business mailing address

18433 ROSCOE BLVD SUITE 203
NORTHRIDGE CA
91325-4108
US

V. Phone/Fax

Practice location:
  • Phone: 818-993-0506
  • Fax: 818-993-8515
Mailing address:
  • Phone: 818-993-0506
  • Fax: 818-993-8515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA35712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: