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General NPI Number Information
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NPI Number | 1679469589
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Entity Type | Organization
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Legal Business Name | SIERRA MED-LEGAL
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 16530 VENTURA BLVD STE D # 526
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City | ENCINO
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State | CA
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Zip | 91436-4554
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Country | US
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Telephone | 818-905-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 16530 VENTURA BLVD STE D # 526
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City | ENCINO
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State | CA
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Zip | 91436-4554
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Country | US
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Telephone | 818-905-2222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHREY KANJIYA
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Credential | MD
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Telephone | 562-905-6536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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