Provider Demographics
NPI:1114059995
Name:SEDGHI, DAVID (MA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SEDGHI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S PALM DR APT 102
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3542
Mailing Address - Country:US
Mailing Address - Phone:310-592-1733
Mailing Address - Fax:
Practice Address - Street 1:110 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3810
Practice Address - Country:US
Practice Address - Phone:323-869-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist