Provider Demographics
NPI:1225031784
Name:HENEIN, SHERIF SAAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERIF
Middle Name:SAAD
Last Name:HENEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHERIF
Other - Middle Name:GABRIEL
Other - Last Name:HENEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:413 BRAXFIELD CT
Mailing Address - Street 2:
Mailing Address - City:LAKE SHERWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5167
Mailing Address - Country:US
Mailing Address - Phone:805-796-5903
Mailing Address - Fax:
Practice Address - Street 1:413 BRAXFIELD CT
Practice Address - Street 2:
Practice Address - City:LAKE SHERWOOD
Practice Address - State:CA
Practice Address - Zip Code:91361-5167
Practice Address - Country:US
Practice Address - Phone:805-796-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49133207R00000X, 207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F29600Medicare UPIN
WA49133AMedicare ID - Type Unspecified