Healthcare Provider Details

I. General information

NPI: 1417291675
Provider Name (Legal Business Name): SADAF REGAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2012
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 JONES WAY STE 9
SIMI VALLEY CA
93065-1218
US

IV. Provider business mailing address

10565 CIVIC CENTER DR STE 250
RANCHO CUCAMONGA CA
91730-3854
US

V. Phone/Fax

Practice location:
  • Phone: 805-915-4440
  • Fax: 805-915-4327
Mailing address:
  • Phone: 909-493-3800
  • Fax: 626-696-1451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA21989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: