Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 103495 | CA |
N | 213EG0000X | General Practice | 103495 | CA |
Y | 1223P0221X | Pediatric Dentist | 103495 | CA |
NPI | 1013471234 |
---|---|
Provider Name | Sara Sanadiki Merhi |
First Address | Ladera Ranch, CA 92694-1201 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2019 |
Last Update Date | 13/08/2019 |