Provider Demographics
NPI:1922103654
Name:LIGONS, SANAA ISHA (DO)
Entity Type:Individual
Prefix:DR
First Name:SANAA
Middle Name:ISHA
Last Name:LIGONS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SANAA
Other - Middle Name:
Other - Last Name:QUANT-LIGONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 4502
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91729-4502
Mailing Address - Country:US
Mailing Address - Phone:909-964-9999
Mailing Address - Fax:909-386-7580
Practice Address - Street 1:665 N D ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1109
Practice Address - Country:US
Practice Address - Phone:909-386-7600
Practice Address - Fax:909-386-7580
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70520FMedicaid
CAFHC70520FMedicaid