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General NPI Number Information
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NPI Number | 1619196870
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Entity Type | Individual
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Provider Name | SUDABEH MOEIN MD
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 700 LAWRENCE EXPY
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City | SANTA CLARA
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State | CA
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Zip | 95051-5173
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Country | US
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Telephone | 408-851-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1512 S DE ANZA BLVD # 190
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City | SAN JOSE
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State | CA
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Zip | 95129-4606
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Country | US
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Telephone | 310-465-9233
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A067561
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License Number State | CA
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