Provider Demographics
NPI:1285748525
Name:SABAHI, HOUMAN (MD)
Entity type:Individual
Prefix:DR
First Name:HOUMAN
Middle Name:
Last Name:SABAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5329
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-0329
Mailing Address - Country:US
Mailing Address - Phone:503-343-7128
Mailing Address - Fax:503-343-7129
Practice Address - Street 1:2111 EXCHANGE ST
Practice Address - Street 2:DEPT OF RADIOLOGY
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3329
Practice Address - Country:US
Practice Address - Phone:503-338-7525
Practice Address - Fax:503-325-1765
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000341512085R0202X
ORMD199772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR133944Medicaid
OR139350Medicare PIN
C51906Medicare UPIN