Provider Demographics
NPI:1528419710
Name:KARANDISH, SAEID (MD)
Entity Type:Individual
Prefix:
First Name:SAEID
Middle Name:
Last Name:KARANDISH
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 1:3733 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-4430
Mailing Address - Country:US
Mailing Address - Phone:818-271-1966
Mailing Address - Fax:
Practice Address - Street 1:16661 VENTURA BLVD STE 311
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1955
Practice Address - Country:US
Practice Address - Phone:800-555-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302638207R00000X
390200000X
CAA171897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program