MEDICARE: EHSAN SAADAT MD

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	207X00000X	Orthopaedic Surgery Physician	L-247771	MA
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	74774	GA
3	207XS0117X	Orthopaedic Surgery of the Spine Physician	A143120	CA

General Provider Information

NPI Number	:	1972899433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EHSAN SAADAT MD

Provider Business Mailing Address
First Line	:	444 S SAN VICENTE BLVD STE 901
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4174
Country	:	US
Telephone Number	:	310-849-4412
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 S SAN VICENTE BLVD STE 901
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4174
Country	:	US
Telephone Number	:	310-849-4412
Fax Number	:

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

Provider Enumeration Date	:	06/23/2011
Last Update Date	:	03/17/2020

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