Provider Demographics
NPI:1225076110
Name:MOUCHARAFIEH, SANA C (MD)
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:C
Last Name:MOUCHARAFIEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 927826
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92192-7826
Mailing Address - Country:US
Mailing Address - Phone:858-450-9116
Mailing Address - Fax:858-450-0158
Practice Address - Street 1:6046 CORNERSTONE CT W STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4733
Practice Address - Country:US
Practice Address - Phone:858-450-9116
Practice Address - Fax:858-450-0158
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC394252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88103Medicare UPIN