Provider Demographics
NPI:1003825571
Name:GILANI, SAPIDEH (MD)
Entity type:Individual
Prefix:
First Name:SAPIDEH
Middle Name:
Last Name:GILANI
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 1:200 W ARBOR DR # MC8895
Mailing Address - Street 2:DIVISION OF OTOLARYNGOLOGY UCSD
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1911
Mailing Address - Country:US
Mailing Address - Phone:619-543-7895
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR # MC8895
Practice Address - Street 2:DIVISION OF OTOLARYNGOLOGY UCSD
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1911
Practice Address - Country:US
Practice Address - Phone:619-543-7895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158214207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA158214OtherTUFTS HEALTH PLAN
MA3191346Medicaid
MAJ19969OtherBLUE CROSS
MA0019997OtherNEIGHBORHOOD HEALTH PLAN
MA0047049-002OtherCIGNA
MAJ214OtherHARVARD PILGRIM
MAJ19969OtherBLUE CROSS
MAHX0550Medicare PIN