Provider Demographics
NPI:1881068633
Name:PARTOVI, SAYEH (PA-C)
Entity type:Individual
Prefix:
First Name:SAYEH
Middle Name:
Last Name:PARTOVI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 18TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2829
Mailing Address - Country:US
Mailing Address - Phone:818-744-1146
Mailing Address - Fax:
Practice Address - Street 1:7232 CANBY AVE STE 456
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-3006
Practice Address - Country:US
Practice Address - Phone:818-705-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53039363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant