Provider Demographics
NPI:1841497070
Name:SABZEVAR, FOROUZAN (MD)
Entity type:Individual
Prefix:DR
First Name:FOROUZAN
Middle Name:
Last Name:SABZEVAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 SEPULVEDA BLVD
Mailing Address - Street 2:#422
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3903
Mailing Address - Country:US
Mailing Address - Phone:818-995-8072
Mailing Address - Fax:
Practice Address - Street 1:3628 E IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2643
Practice Address - Country:US
Practice Address - Phone:310-900-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92479207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA92479BMedicare PIN
CAEC969ZMedicare PIN