1003825571 NPI number — SAPIDEH GILANI MD

Table of content: SAPIDEH GILANI MD (NPI 1003825571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003825571 NPI number — SAPIDEH GILANI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GILANI
Provider First Name:
SAPIDEH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003825571
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 W ARBOR DR # MC8895
Provider Second Line Business Mailing Address:
DIVISION OF OTOLARYNGOLOGY UCSD
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92103-1911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-543-7895
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 W ARBOR DR # MC8895
Provider Second Line Business Practice Location Address:
DIVISION OF OTOLARYNGOLOGY UCSD
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-1911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-7895
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  158214 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 158214 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3191346 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: J19969 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019997 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0047049-002 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J214 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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