Provider Demographics
NPI:1417101809
Name:SANNA, MAIJA BROOKE (MD)
Entity Type:Individual
Prefix:DR
First Name:MAIJA
Middle Name:BROOKE
Last Name:SANNA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:757 WESTWOOD PLZ
Mailing Address - Street 2:RR UCLA MEDICAL CENTER, HOUSESTAFF MAILROOM, ROOM B-711
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8358
Mailing Address - Country:US
Mailing Address - Phone:310-825-7375
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:RR UCLA MEDICAL CENTER, HOUSESTAFF MAILROOM, ROOM B-711
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8358
Practice Address - Country:US
Practice Address - Phone:310-319-4377
Practice Address - Fax:310-319-4425
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2011-05-23
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Provider Licenses
StateLicense IDTaxonomies
CAA102720207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1417101809Medicaid
CADM096ZMedicare PIN