Healthcare Provider Details

I. General information

NPI: 1669593232
Provider Name (Legal Business Name): NATASHA SANE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 CRENSHAW BLVD STE E100
TORRANCE CA
90503-1728
US

IV. Provider business mailing address

16311 VENTURA BLVD STE 1050
ENCINO CA
91436-4347
US

V. Phone/Fax

Practice location:
  • Phone: 310-787-1500
  • Fax:
Mailing address:
  • Phone: 818-783-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA067991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: