Provider Demographics
NPI:1174880397
Name:SINA CORPORATION
Entity type:Organization
Organization Name:SINA CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIFI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:949-724-4000
Mailing Address - Street 1:4229 BIRCH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1959
Mailing Address - Country:US
Mailing Address - Phone:949-724-4000
Mailing Address - Fax:949-679-1905
Practice Address - Street 1:4229 BIRCH ST STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1959
Practice Address - Country:US
Practice Address - Phone:949-724-4000
Practice Address - Fax:949-679-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY508943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1174880397Medicaid