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General NPI Number Information
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NPI Number | 1942318902
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Entity Type | Individual
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Provider Name | MOJGAN SADEGHI MD
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 1164 SWALLOW LN
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City | SIMI VALLEY
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State | CA
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Zip | 93065-3154
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Country | US
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Telephone | 805-583-8000
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Fax | 805-583-8001
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Provider Business Mailing Address
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Address Line | 1164 SWALLOW LN
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City | SIMI VALLEY
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State | CA
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Zip | 93065-3154
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Country | US
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Telephone | 805-583-8000
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Fax | 805-583-8001
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A79902
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License Number State | CA
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