Healthcare Provider Details

I. General information

NPI: 1114318268
Provider Name (Legal Business Name): SARA YEGIYANTS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 09/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 W PUEBLO ST # A
SANTA BARBARA CA
93105-3804
US

IV. Provider business mailing address

3371 GLENDALE BLVD # 470
LOS ANGELES CA
90039-1825
US

V. Phone/Fax

Practice location:
  • Phone: 805-222-0004
  • Fax: 805-682-1730
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SIRANUSH SARA YEGIYANTS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 818-424-0100