Provider Demographics
NPI:1720031255
Name:MOKTAN SHEIKHAI, SABITA (MD)
Entity Type:Individual
Prefix:
First Name:SABITA
Middle Name:
Last Name:MOKTAN SHEIKHAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SABITA
Other - Middle Name:
Other - Last Name:MOKTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-877-5199
Mailing Address - Fax:
Practice Address - Street 1:4475 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-877-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205468207R00000X, 207RE0101X
NV18480207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01647456Medicaid
NY01647456Medicaid
NYG21714Medicare UPIN
G21714Medicare UPIN