Provider Demographics
NPI:1245280007
Name:SARAN, FERDINANT (MD)
Entity type:Individual
Prefix:
First Name:FERDINANT
Middle Name:
Last Name:SARAN
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 1:1510 S CENTRAL AVE STE 515
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2545
Mailing Address - Country:US
Mailing Address - Phone:818-243-4600
Mailing Address - Fax:818-243-4666
Practice Address - Street 1:1510 S CENTRAL AVE STE 515
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2545
Practice Address - Country:US
Practice Address - Phone:818-243-4600
Practice Address - Fax:818-243-4666
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME1878Medicare ID - Type Unspecified
MEI51022Medicare UPIN