Provider Demographics
NPI:1912398785
Name:SADR, BARDIA (MD)
Entity Type:Individual
Prefix:
First Name:BARDIA
Middle Name:
Last Name:SADR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SEYED
Other - Middle Name:BARDIA
Other - Last Name:SADR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2302
Mailing Address - Country:US
Mailing Address - Phone:855-206-6764
Mailing Address - Fax:949-923-3575
Practice Address - Street 1:11 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2302
Practice Address - Country:US
Practice Address - Phone:855-206-6764
Practice Address - Fax:949-923-3575
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA140935207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine