MEDICARE: DR. SANJAY SAHGAL M.D.

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	174400000X	Specialist	G81077	CA
2	2084F0202X	Forensic Psychiatry Physician	G81077	CA

General Provider Information

NPI Number	:	1639153372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJAY SAHGAL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 512717
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-0717
Country	:	US
Telephone Number	:	310-967-1884
Fax Number	:	310-967-1744

Provider Business Practice Location Address
First Line	:	4441 E KINGS CANYON RD
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702-3604
Country	:	US
Telephone Number	:	559-600-9059
Fax Number	:

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	04/26/2021

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