Individual provider Active NPI

Debora Sanam Sedaghat, DO

  • Obstetrics & Gynecology Physician
  • Santa Ana, CA
National Provider Identifier
1578619243
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A10078 Issued in CA
Practice address
520 N. Main St.
Suite 100
Santa Ana, CA 92701
Phone
(714) 953-4242
Fax
(714) 953-4366
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A10078 CA Primary

Addresses

Primary practice location

520 N. Main St.
Suite 100
Santa Ana, CA 92701

Mailing address

11100 Warner Ave
Ste 106
Fountain Valley, CA 92708-7500
Phone (714) 953-4242

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404000390 CA Practitioner - Obstetrics/Gynecology 6608036330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11100 Warner Ave
Suite 106
Fountain Valley, CA 92708-7500
Phone (714) 966-2112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
10078CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Orange Coast Memorial Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1578619243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "STE 106",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087500",
            "telephone_number": "714-953-4242",
            "fax_number": "714-953-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N. MAIN ST.",
            "address_2": "SUITE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92701",
            "telephone_number": "714-953-4242",
            "fax_number": "714-953-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDAGHAT",
        "first_name": "DEBORA",
        "middle_name": "SANAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A10078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.