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General NPI Number Information
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NPI Number | 1376760801
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Entity Type | Individual
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Provider Name | JOHN SEDGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1840 N HACIENDA BLVD SUITE 14
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City | LA PUENTE
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State | CA
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Zip | 91744-1143
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Country | US
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Telephone | 310-429-7078
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Fax | 626-918-6880
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Provider Business Mailing Address
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Address Line | PO BOX 6996
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-6996
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Country | US
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Telephone | 310-429-7078
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Fax | 626-918-6880
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A64492
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License Number State | CA
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