Provider Demographics
NPI:1114318268
Name:SARA YEGIYANTS MD INC
Entity Type:Organization
Organization Name:SARA YEGIYANTS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SIRANUSH
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:YEGIYANTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-424-0100
Mailing Address - Street 1:3371 GLENDALE BLVD # 470
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 W PUEBLO ST # A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3804
Practice Address - Country:US
Practice Address - Phone:805-222-0004
Practice Address - Fax:805-682-1730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty