Provider Demographics
NPI:1891054235
Name:SADR, ELLIKA (MD)
Entity type:Individual
Prefix:MRS
First Name:ELLIKA
Middle Name:
Last Name:SADR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 GRINNELL LN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-3310
Mailing Address - Country:US
Mailing Address - Phone:949-413-5669
Mailing Address - Fax:949-737-1155
Practice Address - Street 1:18 YELLOWWOOD WAY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2723
Practice Address - Country:US
Practice Address - Phone:949-413-5669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFS4568676207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine