Provider Demographics
NPI:1487629051
Name:SADIGHPOUR, MASOUD (MD)
Entity Type:Individual
Prefix:DR
First Name:MASOUD
Middle Name:
Last Name:SADIGHPOUR
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 1:16542 VENTURA BLVD
Mailing Address - Street 2:302
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-5030
Mailing Address - Country:US
Mailing Address - Phone:818-461-9070
Mailing Address - Fax:888-754-1253
Practice Address - Street 1:16542 VENTURA BLVD
Practice Address - Street 2:302
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-5030
Practice Address - Country:US
Practice Address - Phone:818-461-9070
Practice Address - Fax:888-754-1253
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07972900207R00000X
CAA88186207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine