Provider Demographics
NPI:1013187038
Name:SAYANI, SHOHREH (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHOHREH
Middle Name:
Last Name:SAYANI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8435 RESEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4625
Mailing Address - Country:US
Mailing Address - Phone:818-998-6000
Mailing Address - Fax:818-998-6003
Practice Address - Street 1:8435 RESEDA BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4625
Practice Address - Country:US
Practice Address - Phone:818-998-6000
Practice Address - Fax:818-998-6003
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4749213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6296180001Medicare NSC