Healthcare Provider Details

I. General information

NPI: 1881068633
Provider Name (Legal Business Name): SAYEH PARTOVI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2015
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7232 CANBY AVE STE 456
RESEDA CA
91335-3006
US

IV. Provider business mailing address

1417 18TH ST APT 3
SANTA MONICA CA
90404-2829
US

V. Phone/Fax

Practice location:
  • Phone: 818-705-8248
  • Fax:
Mailing address:
  • Phone: 818-744-1146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number53039
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: