Provider Demographics
NPI:1801979760
Name:NOTGHI, SABA (MD)
Entity type:Individual
Prefix:DR
First Name:SABA
Middle Name:
Last Name:NOTGHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18040 SHERMAN WAY
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4631
Mailing Address - Country:US
Mailing Address - Phone:818-758-1200
Mailing Address - Fax:818-758-1360
Practice Address - Street 1:18040 SHERMAN WAY
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4631
Practice Address - Country:US
Practice Address - Phone:818-758-1200
Practice Address - Fax:818-758-1360
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA708052084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABG926OtherMEDICARE GROUP
CAGU852YOtherPTAN
CAH76372Medicare UPIN