Provider Demographics
NPI:1851786370
Name:POORSATTAR, SOPHIA PARVEEN (MD)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:PARVEEN
Last Name:POORSATTAR
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:UCLA DEPT OF ANESTHESIOLOGY RONALD REAGAN CTR
Mailing Address - Street 2:757 WESTWOOD PLAZA, SUITE 3304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095
Mailing Address - Country:US
Mailing Address - Phone:310-267-8655
Mailing Address - Fax:
Practice Address - Street 1:UCLA DEPT OF ANESTHESIOLOGY RONALD REAGAN CTR
Practice Address - Street 2:757 WESTWOOD PLAZA, SUITE 3304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-267-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA146464207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program