MEDICARE: SARA NEJATI FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95033630	CA

General Provider Information

NPI Number	:	1457172223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA NEJATI FNP-BC

Provider Business Mailing Address
First Line	:	4085 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-1942
Country	:	US
Telephone Number	:	323-541-1631
Fax Number	:

Provider Business Practice Location Address
First Line	:	4085 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-1942
Country	:	US
Telephone Number	:	323-541-1631
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	04/21/2026

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