Basic Information
| Provider Information | |||||||||
| NPI: | 1538719554 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAGAR PATEL AESTHETICS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 435 N ROXBURY DR STE 106 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902105003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4243940959 | ||||||||
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| Practice Location | |||||||||
| Address1: | 435 N ROXBURY DR STE 106 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902105003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4243940959 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2019 | ||||||||
| LastUpdateDate: | 08/30/2020 | ||||||||
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| AuthorizedOfficialLastName: | PATEL | ||||||||
| AuthorizedOfficialFirstName: | VIVEK-SAGAR | ||||||||
| AuthorizedOfficialMiddleName: | MUKESH | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4243940959 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 08/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.