Healthcare Provider Details

I. General information

NPI: 1588059059
Provider Name (Legal Business Name): SABA BAGEWADI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AYLA BAGEWADI

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST FL 3
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

15 HOSPITAL DR
YORK ME
03909-1011
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1565
  • Fax:
Mailing address:
  • Phone: 207-351-2478
  • Fax: 207-351-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA169110
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number00000000
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA169110
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA169110
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: