Provider Demographics
NPI:1730636457
Name:AMJADI, SOGOL SARA (DO)
Entity Type:Individual
Prefix:DR
First Name:SOGOL
Middle Name:SARA
Last Name:AMJADI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:024-064-7866
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:8280 W WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3612
Practice Address - Country:US
Practice Address - Phone:702-620-7828
Practice Address - Fax:702-399-8431
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-10
Last Update Date:2023-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVDO2624208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist