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General NPI Number Information
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NPI Number | 1578619243
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Entity Type | Individual
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Provider Name | DEBORA SANAM SEDAGHAT DO
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 520 N. MAIN ST. SUITE 100
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City | SANTA ANA
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State | CA
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Zip | 92701
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Country | US
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Telephone | 714-953-4242
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Fax | 714-953-4366
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Provider Business Mailing Address
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Address Line | 11100 WARNER AVE STE 106
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7500
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Country | US
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Telephone | 714-953-4242
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Fax | 714-953-4366
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 20A10078
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License Number State | CA
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