Provider Demographics
NPI:1881753614
Name:SAHHAR, FRED H (MD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:H
Last Name:SAHHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:130 W ROUTE 66
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-6249
Mailing Address - Country:US
Mailing Address - Phone:626-335-4079
Mailing Address - Fax:626-857-0868
Practice Address - Street 1:130 W ROUTE 66
Practice Address - Street 2:SUITE 208
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6249
Practice Address - Country:US
Practice Address - Phone:626-335-4079
Practice Address - Fax:626-857-0868
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA18957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A189570Medicaid
CAWA18957EMedicare ID - Type Unspecified
CA00A189570Medicaid