Basic Information
Provider Information
NPI: 1760483564
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SARAVIA
FirstName: ANA
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: M.D., MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1172 N MACLAY AVE
Address2:  
City: SAN FERNANDO
State: CA
PostalCode: 913401328
CountryCode: US
TelephoneNumber: 8188981388
FaxNumber: 8183654031
Practice Location
Address1: 12756 VAN NUYS BLVD
Address2:  
City: PACOIMA
State: CA
PostalCode: 913311626
CountryCode: US
TelephoneNumber: 8188960531
FaxNumber: 8188965850
Other Information
ProviderEnumerationDate: 08/03/2005
LastUpdateDate: 12/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XA71189CAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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