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General NPI Number Information
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NPI Number | 1548384746
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Entity Type | Individual
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Provider Name | MORTEZA SAJADIAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 05/11/2008
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Provider Practice Location Address
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Address Line | 1818 N ORANGE GROVE AVE SUITE 202
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City | POMONA
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State | CA
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Zip | 91767-3028
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Country | US
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Telephone | 909-865-3000
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Fax | 909-865-6223
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Provider Business Mailing Address
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Address Line | PO BOX 2016
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City | YORBA LINDA
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State | CA
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Zip | 92885-1216
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Country | US
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Telephone | 714-218-1829
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Fax | 714-777-8967
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C42140
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | HC42140
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | HC42140
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | HC42140
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License Number State | CA
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