Provider Demographics
NPI:1003568676
Name:PATRICK P SASSANI, MD, MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PATRICK P SASSANI, MD, MEDICAL CORPORATION
Other - Org Name:LUX EYE & RETINA - OPHTHALMOLOGY SPECIALISTS OF THE VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:P
Authorized Official - Last Name:SASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-336-1471
Mailing Address - Street 1:14624 SHERMAN WAY STE 506
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2289
Mailing Address - Country:US
Mailing Address - Phone:818-336-1471
Mailing Address - Fax:
Practice Address - Street 1:14624 SHERMAN WAY STE 506
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2289
Practice Address - Country:US
Practice Address - Phone:818-336-1471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty