Dr. Debora Sedaghat OBGYN, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

DR. DEBORA SEDAGHAT OBGYN, INC.

Practice address

11100 Warner Ave
106
Fountain Valley, CA 92708-7506

Phone

(714) 966-2112

Fax

(714) 966-2335

NPI assigned

Jan 4, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Debora Sanam Sedaghat, DONPI 1578619243

Title

OBGYN Physician/President

Phone

(310) 490-2126

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Debora Sanam Sedaghat, DO

  • Obstetrics & Gynecology Physician
  • Santa Ana, CA
  • NPI 1578619243
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1588968697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "106",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-966-2112",
            "fax_number": "714-966-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "106",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-966-2112",
            "fax_number": "714-966-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DEBORA SEDAGHAT OBGYN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "SEDAGHAT",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_middle_name": "SANAM",
        "authorized_official_title_or_position": "OBGYN PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "310-490-2126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1578619243",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.