Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | A80990 | CA |
NPI | 1275604035 |
---|---|
Provider Name | Michelle Lynn Sahagian |
First Address | San Diego, CA 92123-4800 |
Second Address | San Diego, CA 92123-2778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 19/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A809900 | (05) | CA |