Provider Demographics
NPI:1386612489
Name:SABBAGHIAN, BAHMAN (MD)
Entity type:Individual
Prefix:DR
First Name:BAHMAN
Middle Name:
Last Name:SABBAGHIAN
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 1:1307 CROWLEY RAYNE HWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-8210
Mailing Address - Country:US
Mailing Address - Phone:337-783-3624
Mailing Address - Fax:337-783-4265
Practice Address - Street 1:1307 CROWLEY RAYNE HWY
Practice Address - Street 2:SUITE D
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-8210
Practice Address - Country:US
Practice Address - Phone:337-783-3624
Practice Address - Fax:337-783-4265
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020671174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1928003Medicaid
LA5R313Medicare PIN
LA1928003Medicaid