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General NPI Number Information
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NPI Number | 1295344893
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Entity Type | Individual
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Provider Name | PRATIK SAHA M.B.B.S
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Gender | Male
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 3100 CHANNING WAY
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7533
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Country | US
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Telephone | 208-973-2449
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 N TOWN CENTER DR UNIT 2013
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City | LAS VEGAS
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State | NV
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Zip | 89144-0583
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Country | US
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Telephone | 510-415-2813
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 9971442
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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