Healthcare Provider Details

I. General information

NPI: 1609454198
Provider Name (Legal Business Name): SPARGHAI SAHAR LUDIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAHAR LUDIN SAHAR LUDIN, MD

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 10/26/2024
Certification Date: 10/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7930 FROST ST., SUITE 104
SAN DIEGO CA
92123
US

IV. Provider business mailing address

7930 FROST ST., SUITE 104
SAN DIEGO CA
92123
US

V. Phone/Fax

Practice location:
  • Phone: 858-223-2510
  • Fax: 559-635-6126
Mailing address:
  • Phone: 858-223-2510
  • Fax: 858-277-0690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA192286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: