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General NPI Number Information
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NPI Number | 1891852109
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Entity Type | Individual
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Provider Name | JAVID SADJADI M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 11175 CAMPUS ST STE 21111
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City | LOMA LINDA
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State | CA
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Zip | 92350-1700
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Country | US
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Telephone | 909-651-5948
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Fax | 909-558-0236
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Provider Business Mailing Address
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Address Line | 11175 CAMPUS ST STE 21111
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City | LOMA LINDA
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State | CA
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Zip | 92350-1700
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Country | US
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Telephone | 909-651-5948
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Fax | 909-558-0236
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A91633
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License Number State | CA
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