Provider Demographics
NPI:1033278650
Name:SADEGHI, MASOOD H (MD)
Entity type:Individual
Prefix:
First Name:MASOOD
Middle Name:H
Last Name:SADEGHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 DEERMONT RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1027
Mailing Address - Country:US
Mailing Address - Phone:818-437-7022
Mailing Address - Fax:
Practice Address - Street 1:1831 DEERMONT RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-1027
Practice Address - Country:US
Practice Address - Phone:818-437-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34784207ZC0500X
NY223575207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology