Provider Demographics
NPI:1174671499
Name:SHAIK M. SAHEB, MD, INC.
Entity Type:Organization
Organization Name:SHAIK M. SAHEB, MD, INC.
Other - Org Name:ORTHOPEDIC AND SPORTS MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-259-8010
Mailing Address - Street 1:9227 RESEDA BLVD STE 490
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3137
Mailing Address - Country:US
Mailing Address - Phone:661-259-8010
Mailing Address - Fax:661-259-8793
Practice Address - Street 1:18546 ROSCOE BLVD STE 220A
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4663
Practice Address - Country:US
Practice Address - Phone:818-993-4403
Practice Address - Fax:661-259-8793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13286AOtherPTAN
CAW13286AOtherPTAN