Provider Demographics
NPI:1669020327
Name:SFMD MEDICAL LLC
Entity Type:Organization
Organization Name:SFMD MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIYAVASH
Authorized Official - Middle Name:
Authorized Official - Last Name:FOOLADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-795-6596
Mailing Address - Street 1:PO BOX 60790
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6790
Mailing Address - Country:US
Mailing Address - Phone:626-795-6596
Mailing Address - Fax:770-701-6655
Practice Address - Street 1:1211 W LA PALMA AVE STE 301
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2811
Practice Address - Country:US
Practice Address - Phone:714-284-0737
Practice Address - Fax:714-284-0720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty