Organization Active NPI

Sahdev Saharan, M.D., Inc.

  • Rheumatology Physician
  • Stockton, CA
National Provider Identifier
1174822902
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A93889 Issued in CA
Legal business name
SAHDEV SAHARAN, M.D., INC.
Practice address
2800 N California St
Suite 5
Stockton, CA 95204-3757
Phone
(209) 462-7246
Fax
(209) 462-7247
NPI assigned
Mar 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sahdev Saharan, M.D.NPI 1588875512
Title
President
Phone
(209) 462-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X A93889 CA Primary

Addresses

Primary practice location

2800 N California St
Suite 5
Stockton, CA 95204-3757

Mailing address

2800 N California St
Suite 5
Stockton, CA 95204-3757
Phone (209) 462-7246

Other identifiers 1

IdentifierTypeStateIssuer
A93889OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110725000652 CA Part B Supplier - Clinic/Group Practice 6507034220 Receives reassigned benefits from 1 practitioner
Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Locations

2800 N California St
Ste 5
Stockton, CA 95204
Phone (209) 462-7246

3031 W March Ln
#203W
Stockton, CA 95219

3031 W March Ln
Ste 203
Stockton, CA 95219
Phone (209) 462-7246

530 W Eaton Ave
Ste A
Tracy, CA 95376
Phone (209) 565-1070

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1174822902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA ST",
            "address_2": "SUITE 5",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043757",
            "telephone_number": "209-462-7246",
            "fax_number": "209-462-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA ST",
            "address_2": "SUITE 5",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043757",
            "telephone_number": "209-462-7246",
            "fax_number": "209-462-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAHDEV SAHARAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "SAHARAN",
        "authorized_official_first_name": "SAHDEV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-462-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A93889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A93889",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.