Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MAHTAB MOSHTAGH SISAN, MD
ActiveMAHTAB MOSHTAGH SISAN, MD is a Sports Medicine (IM) healthcare provider located in PORTER RANCH, California. NPI 1982197901 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (IM) · PORTER RANCH, CA
Registration Details
- NPI Number
- 1982197901
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 13, 2018 (8.1763227913981 yrs)
- Last Updated
- Dec 1, 2022
- Licenses
-
A173400 (CA)A173400 (CA)
Practice Information
- Address
-
19950 RINALDI ST STE 300PORTER RANCH, CA, 913264141Browse CA providers · Browse ZIP 91326
- Phone
- 8182712400
- Fax
- 8182712401
- Primary Specialty
-
Sports Medicine (IM)
207RS0012X
- Additional Specialty
- Sports Medicine (IM)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.