Provider Demographics
NPI:1518102391
Name:MOSADEGH, SAHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:
Last Name:MOSADEGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 WASHINGTON ST STE 525
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2239
Mailing Address - Country:US
Mailing Address - Phone:619-260-7125
Mailing Address - Fax:
Practice Address - Street 1:501 WASHINGTON ST STE 525
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2239
Practice Address - Country:US
Practice Address - Phone:619-260-7125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC152923208M00000X
AZ45498208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist