Provider Demographics
NPI:1295879245
Name:SAHARA, LYDIA Y (MD)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:Y
Last Name:SAHARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:YANG-LEI
Other - Last Name:ONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:612-371-1673
Practice Address - Street 1:3930 NORTHWOODS DR
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-6963
Practice Address - Country:US
Practice Address - Phone:651-523-8500
Practice Address - Fax:651-523-8584
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18822207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology