Provider Demographics
NPI:1326000217
Name:NAJIBI, SASAN (MD)
Entity Type:Individual
Prefix:
First Name:SASAN
Middle Name:
Last Name:NAJIBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16335
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416-6335
Mailing Address - Country:US
Mailing Address - Phone:818-558-7700
Mailing Address - Fax:818-558-7775
Practice Address - Street 1:2950 W BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2309
Practice Address - Country:US
Practice Address - Phone:818-842-4400
Practice Address - Fax:818-842-4401
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA644852086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A644850Medicaid
CAH76523Medicare UPIN
CA00A644850Medicaid