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General NPI Number Information
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NPI Number | 1174822902
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Entity Type | Organization
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Legal Business Name | SAHDEV SAHARAN, M.D., INC.
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 2800 N CALIFORNIA ST SUITE 5
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City | STOCKTON
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State | CA
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Zip | 95204-3757
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Country | US
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Telephone | 209-462-7246
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Fax | 209-462-7247
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Provider Business Mailing Address
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Address Line | 2800 N CALIFORNIA ST SUITE 5
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City | STOCKTON
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State | CA
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Zip | 95204-3757
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Country | US
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Telephone | 209-462-7246
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Fax | 209-462-7247
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAHDEV SAHARAN
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Credential | M.D.
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Telephone | 209-462-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | A93889
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License Number State | CA
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