Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | E5561 | CA |
Y | 213ES0000X | Sports Medicine | E5561 | CA |
NPI | 1245684166 |
---|---|
Provider Name | Dr. Shahdad K Saeedi |
First Address | Encino, CA 91316-5226 |
Second Address | Encino, CA 91316-5226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2016 |
Last Update Date | 16/11/2020 |