Provider Demographics
NPI:1922074301
Name:SANANI, GUY G (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:G
Last Name:SANANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17822 17TH ST STE 412
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2154
Mailing Address - Country:US
Mailing Address - Phone:714-347-1010
Mailing Address - Fax:714-347-1082
Practice Address - Street 1:311 HAIGH RD STE 100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-3523
Practice Address - Country:US
Practice Address - Phone:805-273-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78839207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB232756Medicare PIN
CAWA78839BMedicare PIN
CACB232755Medicare PIN
CABP661WMedicare PIN
CACB232754Medicare PIN