Provider Demographics
NPI:1760491286
Name:ERFANI, MOHAMMAD SADI (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:SADI
Last Name:ERFANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SADI
Other - Middle Name:
Other - Last Name:ERFANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 210724
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91921-0724
Mailing Address - Country:US
Mailing Address - Phone:619-623-4039
Mailing Address - Fax:619-271-6724
Practice Address - Street 1:8690 CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3057
Practice Address - Country:US
Practice Address - Phone:619-697-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94194208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery