Provider Demographics
NPI:1316236565
Name:PATEL, VIVEK-SAGAR MUKESH (MD)
Entity type:Individual
Prefix:DR
First Name:VIVEK-SAGAR
Middle Name:MUKESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:435 N ROXBURY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5003
Mailing Address - Country:US
Mailing Address - Phone:424-394-0959
Mailing Address - Fax:713-383-3727
Practice Address - Street 1:435 N ROXBURY DR STE 106
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5003
Practice Address - Country:US
Practice Address - Phone:424-394-0959
Practice Address - Fax:713-383-3727
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ7945207Y00000X
CAA156753207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology