Provider Demographics
NPI:1477995744
Name:DOSAJ, SAHIL ANUP (OD)
Entity Type:Individual
Prefix:DR
First Name:SAHIL
Middle Name:ANUP
Last Name:DOSAJ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34806 YUCAIPA BLVD
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-4235
Mailing Address - Country:US
Mailing Address - Phone:909-525-0000
Mailing Address - Fax:
Practice Address - Street 1:34806 YUCAIPA BLVD
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-4235
Practice Address - Country:US
Practice Address - Phone:909-797-0134
Practice Address - Fax:909-797-0137
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003003152W00000X
CA14877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist