Individual provider Active NPI

Saba Sadra, DPM

  • Podiatrist
  • Pomona, CA
National Provider Identifier
1538570841
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5442 Issued in CA
Practice address
795 E. Second St.
Suite 7
Pomona, CA 91766-2007
Phone
(909) 706-3877
Fax
(909) 706-3942
NPI assigned
May 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E5442 CA
Podiatrist 213E00000X E5442 CA Primary

Addresses

Primary practice location

795 E. Second St.
Suite 7
Pomona, CA 91766-2007

Mailing address

795 E. Second St.
Suite 5
Pomona, CA 91766-2007
Phone (909) 865-2565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181217002901 CA Practitioner - Podiatry 8820395932 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5442CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Western University of Health Sciences Podiatrist CurrentSince Nov 1, 2018 Accepting new patients
Western University of Health Sciences CurrentSince Nov 1, 2018 Accepting new patients
Western University of Health Sciences Podiatrist Current Accepting new patients

Locations

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877

795 E 2nd St
Ste 7
Pomona, CA 91766
Phone (909) 469-8673

795 E 2nd St
Ste 8
Pomona, CA 91766
Phone (909) 469-8673

8686 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 706-3950

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1538570841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 E. SECOND ST.",
            "address_2": "SUITE 5",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-865-2565",
            "fax_number": "909-865-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 E. SECOND ST.",
            "address_2": "SUITE 7",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-706-3877",
            "fax_number": "909-706-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADRA",
        "first_name": "SABA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-08",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5442",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.