Provider Demographics
NPI:1144268657
Name:SACHANI, MEHBOOB ANWERALI
Entity type:Individual
Prefix:DR
First Name:MEHBOOB
Middle Name:ANWERALI
Last Name:SACHANI
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:MEHBOOB
Other - Middle Name:ANWERALI
Other - Last Name:SACHANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:18433 ROSCOE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4108
Mailing Address - Country:US
Mailing Address - Phone:818-993-0506
Mailing Address - Fax:818-993-8515
Practice Address - Street 1:18433 ROSCOE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4108
Practice Address - Country:US
Practice Address - Phone:818-993-0506
Practice Address - Fax:818-993-8515
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35712208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB50299Medicare UPIN