Provider Demographics
NPI:1710175229
Name:TEJANI, SABIRA (MD)
Entity Type:Individual
Prefix:
First Name:SABIRA
Middle Name:
Last Name:TEJANI
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 1:711 PEPPER TREE LN
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4731
Mailing Address - Country:US
Mailing Address - Phone:562-209-1342
Mailing Address - Fax:562-598-9390
Practice Address - Street 1:3801 KATELLA AVE STE 115
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3359
Practice Address - Country:US
Practice Address - Phone:562-493-1460
Practice Address - Fax:562-420-9092
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31513207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A315130Medicaid
CAA84225Medicare UPIN
CA00A315130Medicaid