Provider Demographics
NPI:1962026526
Name:JAHANGIRI, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:JAHANGIRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 CHANDLER DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1135
Mailing Address - Country:US
Mailing Address - Phone:714-249-5555
Mailing Address - Fax:
Practice Address - Street 1:2145 CHANDLER DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1135
Practice Address - Country:US
Practice Address - Phone:714-249-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program