Mahtab Moshtagh Sisan, MD
Internal Medicine, Sleep Medicine in Porter Ranch, CA. Individual provider (NPI-1).
NPI number1982197901
StatusActive
Last updated in NPPESDec 1, 2022
Details
- NPI
- 1982197901
- Entity type
- Individual (NPI-1)
- Name
- Mahtab Moshtagh Sisan
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2018
- Certification date
- Dec 1, 2022
- Last updated
- Dec 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RS0012X | Internal Medicine, Sleep Medicine | A173400 | CA | Yes |
| 207Q00000X | Family Medicine | A173400 | CA |
Practice location
19950 Rinaldi St Ste 300Porter Ranch, CA 91326-4141
Phone 818-271-2400 · Fax 818-271-2401
Mailing address
5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631
Phone 310-301-8707 · Fax 310-301-8751
Other practice locations
25775 McBean Pkwy Ste 215
Valencia, CA 91355-3703
Valencia, CA 91355-3703
Phone 661-753-5464 · Fax 661-753-5466
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