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General NPI Number Information
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NPI Number | 1609097088
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Entity Type | Individual
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Provider Name | MEREDITH SAGAN MD
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 16055 VENTURA BLVD STE 1222
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City | ENCINO
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State | CA
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Zip | 91436-2612
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Country | US
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Telephone | 310-614-0711
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Fax | 310-861-0965
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Provider Business Mailing Address
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Address Line | 1223 WILSHIRE BLVD STE 1535
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City | SANTA MONICA
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State | CA
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Zip | 90403-5406
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Country | US
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Telephone | 310-614-0711
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A67988
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License Number State | CA
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