Healthcare Provider Details

I. General information

NPI: 1609513761
Provider Name (Legal Business Name): LAVEENA SEHGAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 N 1ST ST
SAN JOSE CA
95134-1513
US

IV. Provider business mailing address

350 E TAYLOR ST
SAN JOSE CA
95112-3161
US

V. Phone/Fax

Practice location:
  • Phone: 408-871-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA206315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: