Provider Demographics
NPI:1356897573
Name:SANI AND ESHAGHIAN M.D., INC.
Entity type:Organization
Organization Name:SANI AND ESHAGHIAN M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ESHAGHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:818-366-2977
Mailing Address - Street 1:17075 DEVONSHIRE ST
Mailing Address - Street 2:SUITE #205
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1600
Mailing Address - Country:US
Mailing Address - Phone:818-366-2977
Mailing Address - Fax:
Practice Address - Street 1:17075 DEVONSHIRE ST
Practice Address - Street 2:SUITE #205
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1600
Practice Address - Country:US
Practice Address - Phone:818-366-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111635207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA626685414Medicare UPIN