Provider Demographics
NPI:1295061786
Name:MOBASSER, SARVENAZ SAADAT (MD)
Entity type:Individual
Prefix:DR
First Name:SARVENAZ
Middle Name:SAADAT
Last Name:MOBASSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARVENAZ
Other - Middle Name:SHARON
Other - Last Name:SAADAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-0299
Mailing Address - Country:US
Mailing Address - Phone:310-963-2680
Mailing Address - Fax:206-984-9849
Practice Address - Street 1:204 E PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-2508
Practice Address - Country:US
Practice Address - Phone:213-457-4000
Practice Address - Fax:206-984-9849
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine