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General NPI Number Information
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NPI Number | 1588968697
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Entity Type | Organization
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Legal Business Name | DR. DEBORA SEDAGHAT OBGYN, INC.
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 11100 WARNER AVE 106
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7506
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Country | US
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Telephone | 714-966-2112
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Fax | 714-966-2335
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Provider Business Mailing Address
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Address Line | 11100 WARNER AVE 106
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7506
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Country | US
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Telephone | 714-966-2112
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Fax | 714-966-2335
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Authorized Official
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Title or Position | OBGYN PHYSICIAN/PRESIDENT
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Name | DR. DEBORA SANAM SEDAGHAT
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Credential | DO
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Telephone | 310-490-2126
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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 |
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License Number State |
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