Provider Demographics
NPI:1225212988
Name:SADEGHI, HOMAYOUN
Entity Type:Individual
Prefix:
First Name:HOMAYOUN
Middle Name:
Last Name:SADEGHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 S BEVERLY DRIVE #3861
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1985
Mailing Address - Country:US
Mailing Address - Phone:310-278-5700
Mailing Address - Fax:
Practice Address - Street 1:312 S BEVERLY DRIVE #3861
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1985
Practice Address - Country:US
Practice Address - Phone:310-278-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT390200000X207VE0102X
CAA93041207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology