Provider Demographics
NPI:1356664429
Name:SABET-PEYMAN, ESFANDIAR JASON (MD)
Entity Type:Individual
Prefix:
First Name:ESFANDIAR
Middle Name:JASON
Last Name:SABET-PEYMAN
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 1:301 W BASTANCHURY RD STE 190
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3429
Mailing Address - Country:US
Mailing Address - Phone:714-449-1940
Mailing Address - Fax:714-449-1988
Practice Address - Street 1:301 W BASTANCHURY RD STE 190
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3429
Practice Address - Country:US
Practice Address - Phone:714-449-1940
Practice Address - Fax:714-449-1988
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-01121207W00000X
CAA109912207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA123500Medicare PIN