Provider Demographics
NPI:1518474816
Name:MADAN, SAKSHI (PA-C)
Entity Type:Individual
Prefix:
First Name:SAKSHI
Middle Name:
Last Name:MADAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14442 WHITTIER BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2162
Mailing Address - Country:US
Mailing Address - Phone:562-945-1940
Mailing Address - Fax:562-945-1855
Practice Address - Street 1:14442 WHITTIER BLVD STE 105
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2162
Practice Address - Country:US
Practice Address - Phone:562-945-1940
Practice Address - Fax:562-945-1855
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA55336363A00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical